Michael William Allard, D.C.
Individual provider Active NPI Chiropractor · Norwich, CT
NPI 1619001880 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619001880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1294 (CT)
- Practice address
- 598 W Main St
Norwich, CT 06360-5342 - Phone
- (860) 889-1475
- Fax
- (860) 889-2850
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
68 Salem Tpke
Norwich, CT 06360-6527
Phone (860) 889-1475
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050518000722 | CT | Practitioner - Chiropractic | 9335180553 | Practice locations: Norwich, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001294 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Medical-Mystic, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1294 | CT | Yes |
Addresses
Primary practice location
598 W Main St
Norwich, CT 06360-5342
Mailing address
598 W Main St
Norwich, CT 06360-5342
Phone (860) 889-1475
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050001294CT04 | Other | CT | ANTHEM BCBS |
| 0005756755 | Other | CT | AETNA |
| P2897777 | Other | CT | OXFORD |
Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.