Active NPI
Clark Chiropractic Center, LLC
- Rehabilitation Chiropractor
- Cromwell, CT
National Provider Identifier
1548532831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 001321
- Legal business name
- CLARK CHIROPRACTIC CENTER, LLC
- Practice address
- 154 West St
Suite E
Cromwell, CT 06416-4400 - Phone
- (860) 632-1668
- Fax
- (860) 632-1672
- NPI assigned
- Feb 1, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William F Clark, D.C.
- Title
- President
- Phone
- (860) 632-1668
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 001321 | CT | Primary |
Addresses
Primary practice location
154 West St
Suite E
Cromwell, CT 06416-4400
Mailing address
154 West St
Suite E
Cromwell, CT 06416-4400
Phone (860) 632-1668
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U75980 | Other | LIBERTY MUTUTAL | |
| 050001321CT02 | Other | CT | ANTHEM BLUE CROSS/BLUE SHIELD |
| 4409341-002 | Other | CT | CIGNA |
| 611244 | Other | AMERICAN CHIROPRACTIC NETWORK | |
| 905871CONN | Other | PHCS PRIVATE HEALTHCARE SYSTEMS | |
| P2773574 | Other | OXFORD | |
| U75980 | Other | HEALTH MANAGEMENT CENTER | |
| 1397991 | Other | CT | AIG |
| U75980 | Other | WEBSTER | |
| 132100 | Other | CONNECTICARE | |
| 1740360049 | Other | CHN NHD | |
| 44-04334 | Other | UNITED HEALTHCARE | |
| 7139035 | Other | AETNA | |
| U75980 | Other | GAB ROBBINS |
National Provider Directory
National Provider DirectoryLocations
154 West St
Cromwell, CT 06416
Phone (860) 632-1668
154 West St
Ste E
Cromwell, CT 06416
Phone (860) 632-1668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328054400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1328054400000",
"number": "1548532831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 WEST ST",
"address_2": "SUITE E",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064164400",
"telephone_number": "860-632-1668",
"fax_number": "860-632-1672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 WEST ST",
"address_2": "SUITE E",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064164400",
"telephone_number": "860-632-1668",
"fax_number": "860-632-1672"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARK CHIROPRACTIC CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-01",
"last_updated": "2012-02-01",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "860-632-1668",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": "CT",
"license": "001321",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIBERTY MUTUTAL",
"identifier": "U75980",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS/BLUE SHIELD",
"identifier": "050001321CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4409341-002",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN CHIROPRACTIC NETWORK",
"identifier": "611244",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS PRIVATE HEALTHCARE SYSTEMS",
"identifier": "905871CONN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2773574",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH MANAGEMENT CENTER",
"identifier": "U75980",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AIG",
"identifier": "1397991",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEBSTER",
"identifier": "U75980",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "132100",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHN NHD",
"identifier": "1740360049",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "44-04334",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7139035",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GAB ROBBINS",
"identifier": "U75980",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cromwell, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.