Organization Active NPI

Southern Connecticut Muscle and Joint Performance Chiropractic

  • Rehabilitation Chiropractor
  • Branford, CT
National Provider Identifier
1598063455
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
001874 Issued in CT
Legal business name
SOUTHERN CONNECTICUT MUSCLE AND JOINT PERFORMANCE CHIROPRACTIC
Practice address
491 Main St
Branford, CT 06405-3505
Phone
(203) 640-6302
Fax
(203) 433-4277
NPI assigned
Mar 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Armand Gagliardi, D.C.NPI 1205168762
Title
Owner
Phone
(203) 640-6302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 001874 CT Primary

Addresses

Primary practice location

491 Main St
Branford, CT 06405-3505

Mailing address

491 Main St
Branford, CT 06405-3505
Phone (203) 640-6302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110428000726 CT Part B Supplier - Clinic/Group Practice 1456536853 Receives reassigned benefits from 1 practitioner
Practice locations: Branford, CT

National Provider Directory

National Provider Directory

Locations

5 S Main St
Ste 511
Branford, CT 06405
Phone (203) 208-0972

491 Main St
Branford, CT 06405
Phone (203) 483-4383

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1598063455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053505",
            "telephone_number": "203-640-6302",
            "fax_number": "203-433-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053505",
            "telephone_number": "203-640-6302",
            "fax_number": "203-433-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CONNECTICUT MUSCLE AND JOINT PERFORMANCE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "GAGLIARDI",
        "authorized_official_first_name": "ARMAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-640-6302",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CT",
            "license": "001874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.