Active NPI
Mary Lavin Mooradian, D.C.
- Chiropractor
- New London, CT
National Provider Identifier
1598706160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 000593
- Practice address
- 377 Colman St
New London, CT 06320-3713 - Phone
- (860) 444-6363
- Fax
- (860) 443-3314
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 000593 | CT | Primary |
Addresses
Primary practice location
377 Colman St
New London, CT 06320-3713
Mailing address
377 Colman St
New London, CT 06320-3713
Phone (860) 444-6363
Other names 1
- Dr. Mary Lavin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060802000452 | CT | Practitioner - Chiropractic | 2961415278 |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1986
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
774 Broad St Ext
Waterford, CT 06385-1303
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000593 | CT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ewcw LLC | Chiropractor | Current | Accepting new patients |
| Eastern Shore Chiropractic Center, L.L.C. | Chiropractor | Past | Accepting new patients |
Locations
774 Broad Street Ext
#2
Waterford, CT 06385
774 Broad Street Ext
Waterford, CT 06385
Phone (860) 444-6363
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- New London, CT
- NPI 1992752596
-
- Chiropractor
- Waterford, CT
- NPI 1144107954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226620800000",
"number": "1598706160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 COLMAN ST",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063203713",
"telephone_number": "860-444-6363",
"fax_number": "860-443-3314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 COLMAN ST",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063203713",
"telephone_number": "860-444-6363",
"fax_number": "860-443-3314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORADIAN",
"first_name": "MARY",
"middle_name": "LAVIN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2008-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "000593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "LAVIN",
"prefix": "DR.",
"credential": "D.C.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.