Individual provider Active NPI

Timothy Marcel Ouellette, DC

  • Chiropractor
  • Plainville, CT
National Provider Identifier
1619570090
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002134 Issued in CT
Practice address
43 East St
Plainville, CT 06062-2308
Phone
(860) 793-6824
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 002134 CT Primary

Addresses

Primary practice location

43 East St
Plainville, CT 06062-2308

Mailing address

43 East St
Plainville, CT 06062-2308
Phone (860) 793-6824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210106003044 CT Practitioner - Chiropractic 3971916131 Reassigns benefits to 1 organization
Practice locations: Plainville, CT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

43 E St
Plainville, CT 06062-2308
Phone (860) 793-6824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002134CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Plainville Chiropractic Inc Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Plainville Chiropractic LLC Chiropractor CurrentSince Nov 22, 2020 Accepting new patients

Locations

43 East St
Plainville, CT 06062
Phone (860) 793-6824

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.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1619570090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622308",
            "telephone_number": "860-793-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622308",
            "telephone_number": "860-793-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "TIMOTHY",
        "middle_name": "MARCEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "002134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.

Verify at the official NPI Registry.