Central Connecticut Chiropractic, PC
Organization Active NPI Sports Physician Chiropractor · Kensington, CT
NPI 1528087749 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1528087749
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Physician Chiropractor 111NS0005X
- License
- 000759 (CT)
- Legal business name
- CENTRAL CONNECTICUT CHIROPRACTIC, PC
- Practice address
- 36 Chamberlain Hwy
Kensington, CT 06037-1921 - Phone
- (860) 828-3435
- Fax
- (860) 828-1203
- NPI assigned
- Jul 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Michele Imossi, D.C.
- Title
- President/Director
- Phone
- (860) 828-3435
Practitioners 5
-
Michele Imossi, D.C.
-
Morgan Imossi, CNS, CD-N
-
Darline Maitland, AA,BA,DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421000650 | CT | Part B Supplier - Clinic/Group Practice | 8921094590 |
Receives reassigned benefits from 1 practitioner Practice locations: Kensington, CT |
National Provider Directory
Locations
36 Chamberlain Hwy
Kensington, CT 06037
Phone (860) 828-3435
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor |
111NS0005X | 000759 | CT | Yes |
Addresses
Primary practice location
36 Chamberlain Hwy
Kensington, CT 06037-1921
Mailing address
36 Chamberlain Hwy
Kensington, CT 06037-1921
Phone (860) 828-3435
Other providers in Kensington, CT
- Constantine Scott Buonanno
- C. Scott Buonanno DMD & Associates PC
- Phillip John Candito
- Caring Hearts Home Services LLC
- Center for Urology Care
- Stanislaw Piotr Chorzepa
- Eugene M. Ciccone
- Connecticut CVS Pharmacy, L.L.C.
- Connecticut Foot Care Centers LLC
- Raphael M Cooper
All providers in Kensington, CT · Sports Physician Chiropractor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.