Organization Active NPI

Hodes Chiropractic LLC

  • Chiropractor
  • Waterbury, CT
National Provider Identifier
1619317443
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
000899 Issued in CT
Legal business name
HODES CHIROPRACTIC LLC
Practice address
1249 W Main St
Suite 7
Waterbury, CT 06708-3100
Phone
(203) 754-2300
Fax
(203) 754-2301
NPI assigned
Jun 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Dr. Scott A Hodes, D.C.NPI 1912964826
Title
Owner
Phone
(203) 754-2300

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 000899 CT Primary

Addresses

Primary practice location

1249 W Main St
Suite 7
Waterbury, CT 06708-3100

Mailing address

1249 W Main St
Suite 7
Waterbury, CT 06708-3100
Phone (203) 754-2300

Other identifiers 10

IdentifierTypeStateIssuer
1912964826OtherCTNPI
2113832OtherCTAETNA
NHS467OtherCTOXFORD
000001470878OtherCTPRIVATE HEALTHCARE SYSTEM
050000899CT02OtherCTANTHEM BLUE CROSS
4298598OtherCTAETNA
745717OtherCTCONNECTICARE
050000899CT04OtherCTBLUE CROSS BLUE SHIELD
71314OtherCTAMERICAN SPECIALTY
742701OtherCTCONNECTICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131119001961 CT Part B Supplier - Clinic/Group Practice 5395971477 Receives reassigned benefits from 1 practitioner
Practice locations: Waterbury, CT

National Provider Directory

National Provider Directory

Locations

1249 W Main St
Ste 7
Waterbury, CT 06708
Phone (203) 754-2300

Practitioners & affiliated clinicians

Practitioners 1

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": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1619317443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 W MAIN ST",
            "address_2": "SUITE 7",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083100",
            "telephone_number": "203-754-2300",
            "fax_number": "203-754-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 W MAIN ST",
            "address_2": "SUITE 7",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083100",
            "telephone_number": "203-754-2300",
            "fax_number": "203-754-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODES CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "HODES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-754-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912964826",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2113832",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NHS467",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "000001470878",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "050000899CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4298598",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "745717",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "050000899CT04",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY",
            "identifier": "71314",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "742701",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.