Beth S Goulding, D.C. – Chiropractor in East Lyme, CT

Key facts

NPI: 1790713089
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 000325 (CT)
Practice address: 126 Boston Post Rd
East Lyme, CT 06333-1606
Phone: (860) 739-3927
Fax: (860) 739-3928
NPI assigned: Jun 28, 2006
Sex: Female
Sole proprietor: No

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.

Healthsource of East Lyme LLC Chiropractor · East Lyme, CT · NPI 1790965267

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
000325	CT	MD	Naturopath

Practice roles

Organization	Specialty	Status	New patients
Healthsource of East Lyme LLC	Chiropractor	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	000325	CT	Yes

Addresses

Primary practice location

126 Boston Post Rd
East Lyme, CT 06333-1606

Mailing address

126 Boston Post Rd
East Lyme, CT 06333-1606
Phone (860) 739-3927

Other identifiers

Identifier	Type	State	Issuer
050000325CT01	Other	CT	ANTHEM BC/BS
CT00325	Other	CT	LANDMARK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790713089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 BOSTON POST RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331606",
            "telephone_number": "860-739-3927",
            "fax_number": "860-739-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 BOSTON POST RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331606",
            "telephone_number": "860-739-3927",
            "fax_number": "860-739-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDING",
        "first_name": "BETH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "050000325CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LANDMARK",
            "identifier": "CT00325",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lyme, CT

All providers in East Lyme, CT · Chiropractor in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.