Kent Chiropractic Associates LLC
Organization Active NPI Chiropractor · Kent, CT
NPI 1669944542 · NPPES record last updated Aug 18, 2023
Key facts
- NPI
- 1669944542
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- KENT CHIROPRACTIC ASSOCIATES LLC
- Practice address
- 64 Maple St
Kent, CT 06757-1721 - Phone
- (860) 502-5908
- Fax
- (860) 773-0608
- NPI assigned
- Dec 17, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Chikezie Ijomah, DC
- Title
- Owner
- Phone
- (860) 502-5908
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190925002686 | CT | Part B Supplier - Clinic/Group Practice | 1951631407 |
Receives reassigned benefits from 1 practitioner Practice locations: East Berlin, CT; Kent, CT |
National Provider Directory
Locations
1224 Mill St
#A201
East Berlin, CT 06023
Phone (860) 592-0073
64 Maple St
Kent, CT 06757
Phone (860) 419-5925
27 N Main St
Unit 7A
Kent, CT 06757
Phone (203) 574-5997
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
64 Maple St
Kent, CT 06757-1721
Mailing address
PO Box 912
Kent, CT 06757-0912
Other providers in Kent, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.