Organization Active NPI

Chiropractic Life and Wellness Center, LLC

  • Chiropractor
  • New Fairfield, CT
National Provider Identifier
1740616309
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001704 Issued in CT
Legal business name
CHIROPRACTIC LIFE AND WELLNESS CENTER, LLC
Practice address
3 State Route 39
New Fairfield, CT 06812-4000
Phone
(203) 746-6543
Fax
(203) 746-7321
NPI assigned
Sep 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
Dr. Brandon Chorney, DCNPI 1467509901
Title
Chiropractor
Phone
(203) 746-6543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 001704 CT Primary

Addresses

Primary practice location

3 State Route 39
New Fairfield, CT 06812-4000

Mailing address

3 State Route 39
New Fairfield, CT 06812-4000
Phone (203) 746-6543

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131204001791 CT Part B Supplier - Clinic/Group Practice 1456587039 Receives reassigned benefits from 1 practitioner
Practice locations: New Fairfield, CT

National Provider Directory

National Provider Directory

Locations

3 State Route 39
New Fairfield, CT 06812
Phone (203) 746-2429

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1740616309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STATE ROUTE 39",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068124000",
            "telephone_number": "203-746-6543",
            "fax_number": "203-746-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 STATE ROUTE 39",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068124000",
            "telephone_number": "203-746-6543",
            "fax_number": "203-746-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC LIFE AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "CHORNEY",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "203-746-6543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.