Individual provider Active NPI

Robert M Shortell, D.C.

  • Chiropractor
  • Cromwell, CT
National Provider Identifier
1679571053
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001242 Issued in CT
Practice address
28 Shunpike Rd
Cromwell, CT 06416-2454
Phone
(860) 635-4455
Fax
(860) 635-0499
NPI assigned
Jul 11, 2005
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001242 CT Primary

Addresses

Primary practice location

28 Shunpike Rd
Cromwell, CT 06416-2454

Mailing address

4 Breezy Corners Rd
Portland, CT 06480-1711
Phone (860) 342-1636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120222000703 CT Practitioner - Chiropractic 0042478067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Shunpike Rd
Suite 4
Cromwell, CT 06416-2454
Phone (860) 635-4455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001242CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cromwell Chiropractic Center, LLC Chiropractor CurrentSince Apr 1, 1998 Accepting new patients

Locations

28 Shunpike Rd
Cromwell, CT 06416
Phone (860) 635-1595

28 Shunpike Rd
Ste 4
Cromwell, CT 06416
Phone (860) 635-4455

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1679571053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BREEZY CORNERS RD",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801711",
            "telephone_number": "860-342-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162454",
            "telephone_number": "860-635-4455",
            "fax_number": "860-635-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTELL",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.