Individual provider Active NPI

Shawn Carlin, DC

  • Chiropractor
  • Bronx, NY
National Provider Identifier
1700264694
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10062 Issued in NY
Practice address
3262 Westchester Ave
Bronx, NY 10461-4510
Phone
(718) 904-0908
Fax
(718) 904-0352
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10062 NY Primary

Addresses

Primary practice location

3262 Westchester Ave
Bronx, NY 10461-4510

Mailing address

162 Boggs Hill Rd
Newtown, CT 06470-1969
Phone (914) 760-3449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103002782 CT Practitioner - Chiropractic 2860702875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19 Padanaram Rd
Suite 202
Danbury, CT 06811-4816
Phone (203) 830-3003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10062NYMDChiropractor
001962CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Chiropractic, LLC Chiropractor CurrentSince Sep 6, 2015 Accepting new patients

Locations

19 Padanaram Rd
Ste 202
Danbury, CT 06811
Phone (203) 830-3003

94 Locust Ave
Danbury, CT 06810
Phone (203) 748-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1700264694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 BOGGS HILL RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701969",
            "telephone_number": "914-760-3449",
            "fax_number": "203-364-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3262 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614510",
            "telephone_number": "718-904-0908",
            "fax_number": "718-904-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLIN",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "10062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.