Active NPI
Kenneth Landry, D.C.
- Chiropractor
- Enfield, CT
National Provider Identifier
1851342992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 001461
- Practice address
- 546 Enfield St
Enfield, CT 06082-2408 - Phone
- (860) 265-3792
- NPI assigned
- May 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2225 | MA | |
| Chiropractor | 111N00000X | 001461 | CT | Primary |
Addresses
Primary practice location
546 Enfield St
Enfield, CT 06082-2408
Mailing address
546 Enfield St
Enfield, CT 06082-2408
Phone (860) 265-3792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y36882 | Other | MA | BLUECROSS BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001461 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1851342992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 ENFIELD ST",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060822408",
"telephone_number": "860-265-3792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "546 ENFIELD ST",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060822408",
"telephone_number": "860-265-3792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "KENNETH",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "2225",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "001461",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "Y36882",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.