Life Family Chiropractic of Portland, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIFE FAMILY CHIROPRACTIC OF PORTLAND, LLC

Practice address

234 Main St
Portland, CT 06480-1861

Phone

(860) 342-7277

Fax

(860) 342-7281

NPI assigned

Feb 18, 2021

Last updated

Feb 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Koster, DC

Title

Managing Member

Phone

(860) 384-0494

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Malton, D.C.

  • Chiropractor
  • Portland, CT
  • NPI 1659578342
  Medicare reassignment NPD

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1699368746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801861",
            "telephone_number": "860-342-7277",
            "fax_number": "860-342-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801861",
            "telephone_number": "860-342-7277",
            "fax_number": "860-342-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FAMILY CHIROPRACTIC OF PORTLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "KOSTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "860-384-0494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Kehoe, LMSW
• Khushi, LLC (Waterview Dental Group)
• Sarah Melissa Kopac, MFT
• Joseph Lantos, DDS
• Yilan Liang
• Lori Orend, LCSW LLC
• Robert R. Malafronte, LCSW
• Timothy Malton, D.C.
• Micaela Mellow, LPCA
• MHS Primary Care (George Rosenfeld, MD)

• Chiropractor in Portland, CT
• Providers in Portland, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.