Active NPI
Lawrence Michael Wilner, DC
- Massage Therapist
- Shelton, CT
National Provider Identifier
1770632127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 000862
- Practice address
- 3 Corporate Drive
Suite 160
Shelton, CT 06484 - Phone
- (203) 929-5500
- Fax
- (203) 926-1220
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 000862 | CT | |
| Rehabilitation Chiropractor | 111NR0400X | 000862 | CT | |
| Massage Therapist | 225700000X | 000862 | CT | Primary |
Addresses
Primary practice location
3 Corporate Drive
Suite 160
Shelton, CT 06484
Mailing address
3 Corporate Drive
Suite 160
Shelton, CT 06484
Phone (203) 929-5500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050000862CT01 | Other | CT | ANTHEM BCBS |
| CV2880 | Other | CT | HEALTHNET LANDMARK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070828000378 | CT | Practitioner - Chiropractic | 7416049010 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000862 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1770632127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CORPORATE DRIVE",
"address_2": "SUITE 160",
"city": "SHELTON",
"state": "CT",
"postal_code": "06484",
"telephone_number": "203-929-5500",
"fax_number": "203-926-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 CORPORATE DRIVE",
"address_2": "SUITE 160",
"city": "SHELTON",
"state": "CT",
"postal_code": "06484",
"telephone_number": "203-929-5500",
"fax_number": "203-926-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILNER",
"first_name": "LAWRENCE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "000862",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CT",
"license": "000862",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "000862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "050000862CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET LANDMARK",
"identifier": "CV2880",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shelton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.