Active NPI
Jens Antoni Korgaard, D.C
- Chiropractor
- Newington, CT
National Provider Identifier
1871664474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 001413
- Practice address
- 1268 Main St
Suite 105
Newington, CT 06111-3038 - Phone
- (860) 667-4722
- Fax
- (860) 667-1022
- NPI assigned
- Nov 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 001413 | CT | Primary |
Addresses
Primary practice location
1268 Main St
Suite 105
Newington, CT 06111-3038
Mailing address
1268 Main St
Suite 105
Newington, CT 06111-3038
Phone (860) 667-4722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050705000644 | CT | Practitioner - Chiropractic | 3274579818 | Practice locations: Newington, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1992
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1268 Main St
Suite 105
Newington, CT 06111-3043
Phone (860) 667-4722
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1413 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871664474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1268 MAIN ST",
"address_2": "SUITE 105",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061113038",
"telephone_number": "860-667-4722",
"fax_number": "860-667-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1268 MAIN ST",
"address_2": "SUITE 105",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061113038",
"telephone_number": "860-667-4722",
"fax_number": "860-667-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORGAARD",
"first_name": "JENS",
"middle_name": "ANTONI",
"name_prefix": "Dr.",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "001413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.