Individual provider Active NPI

Richard Gary Coopersmith, D.C.

  • Chiropractor
  • Newtown, CT
National Provider Identifier
1629135561
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
205 Issued in CT
Practice address
54 S Main St
Newtown, CT 06470-2358
Phone
(203) 426-2490
Fax
(203) 426-8631
NPI assigned
Jan 2, 2007
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 205 CT Primary

Addresses

Primary practice location

54 S Main St
Newtown, CT 06470-2358

Mailing address

54 S Main St
Newtown, CT 06470-2358
Phone (203) 426-2490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001024 CT Practitioner - Chiropractic 1557348174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
205CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Newtown LLC Chiropractor CurrentSince Oct 1, 1984 Accepting new patients

Locations

54 S Main St
Newtown, CT 06470
Phone (203) 270-1077

Organizations & group practices 1

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1629135561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 S MAIN ST",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702358",
            "telephone_number": "203-426-2490",
            "fax_number": "203-426-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 S MAIN ST",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702358",
            "telephone_number": "203-426-2490",
            "fax_number": "203-426-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERSMITH",
        "first_name": "RICHARD",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.