Individual provider Active NPI

Michael Thomas, DC

  • Chiropractor
  • Groton, CT
National Provider Identifier
1629098330
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1102 Issued in CT
Practice address
565 Long Hill Rd
Groton, CT 06340-4134
Phone
(860) 448-2225
Fax
(860) 446-0784
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1102 CT Primary

Addresses

Primary practice location

565 Long Hill Rd
Groton, CT 06340-4134

Mailing address

565 Long Hill Rd
Groton, CT 06340-4134
Phone (860) 448-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050221000450 CT Practitioner - Chiropractic 2466404249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Advanced Back and Neck Care Center LLCGroup PAC ID 7315999190, 5 clinicians

Practice addresses (Care Compare)

565 Long Hill Rd
Groton, CT 06340-4166
Phone (860) 448-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1102CTMDBehavioral Analyst
001102CTMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Back and Neck Care Center LLC Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Main Medical-Mystic, LLC PastSince Jul 12, 2002 Accepting new patients

Locations

565 Long Hill Rd
Groton, CT 06340
Phone (401) 596-5695

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629098330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 LONG HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404134",
            "telephone_number": "860-448-2225",
            "fax_number": "860-446-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 LONG HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404134",
            "telephone_number": "860-448-2225",
            "fax_number": "860-446-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.