Dr Rebecca Green

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001023 Issued in CT

Legal business name

DR REBECCA GREEN

Practice address

121 Broadway
Suite 2
Colchester, CT 06415

Phone

(860) 537-8900

Fax

(860) 537-8868

NPI assigned

Dec 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rebecca A Green, DC DACBSPNPI 1013106046

Title

Owner

Phone

(860) 537-8900

Specialties & licenses 2

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca A Green, DC, DACBSP

  • Sports Physician Chiropractor
  • Colchester, CT
  • NPI 1013106046
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477614519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BROADWAY",
            "address_2": "SUITE 2",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "06415",
            "telephone_number": "860-537-8900",
            "fax_number": "860-537-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BROADWAY",
            "address_2": "SUITE 2",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "06415",
            "telephone_number": "860-537-8900",
            "fax_number": "860-537-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR REBECCA GREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-537-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC DACBSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001023",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "0CP00506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3984974",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CT01023",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "050001023CT04",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Diaz
• Alicia Dinda
• Christopher Dipasquale, PT, OSC, SCS, CHT
• Olivia Dolan, MA CCC-SLP
• Kayla Donovan, ATC
• Dr Steven C Lakes DMD
• DRS Park, Zase and Babinski (Colchester Dental Group, LLC)
• Jacqueline M Durand, RD
• E and P Therapy, LLC
• Eastern Connecticut Rehabilitation Centers

• Chiropractor in Colchester, CT
• Providers in Colchester, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.