Dr Michael Ijomah DC LLC

Key facts

NPI

1881336063

Entity type

Organization (NPI type 2)

Primary specialty

Chiropractor 111N00000X

Legal business name

DR MICHAEL IJOMAH DC LLC

Practice address

1224 Mill St Unit 201
East Berlin, CT 06023-1159

Phone

(860) 592-0073

Fax

(860) 773-0608

NPI assigned

Apr 8, 2022

Organization subpart

No

Authorized official

Name

Dr. Michael Chikezie Ijomah, DC NPI 1598121428

Title

Owner

Phone

(860) 502-5908

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Chikezie Ijomah, DC Chiropractor · Simsbury, CT · NPI 1598121428
  NPD Authorized official CHIROPRACTOR

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 8, 2022.

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1881336063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067570912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 MILL ST UNIT 201",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231159",
            "telephone_number": "860-592-0073",
            "fax_number": "860-773-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MICHAEL IJOMAH DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "IJOMAH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHIKEZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-502-5908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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