Healthsource of East Lyme LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

000310 Issued in CT

Legal business name

HEALTHSOURCE OF EAST LYME LLC

Practice address

126 Boston Post Rd
East Lyme, CT 06333-1606

Phone

(860) 739-3927

NPI assigned

Nov 13, 2007

Last updated

Feb 24, 2014By 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. Thomas B Goulding, D.C.NPI 1487682795

Title

Owner

Phone

(860) 739-3927

Specialties & licenses 1

Addresses

Other names 1

• Sunrise Wellness Center LLC Former legal business name

Practitioners 2

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.

• Thomas B Goulding, D.C.

  • Chiropractor
  • East Lyme, CT
  • NPI 1487682795
  NPD (past) Authorized official
• Beth S Goulding, D.C.

  • Chiropractor
  • East Lyme, CT
  • NPI 1790713089
  NPD (past)

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1790965267",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF EAST LYME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "GOULDING",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-739-3927",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Wellness Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Chiropractor in East Lyme, CT
• Providers in East Lyme, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.