Individual provider Active NPI

Mara Sussman Tabares, D.C.

  • Chiropractor
  • Danbury, CT
National Provider Identifier
1912959164
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1339 Issued in CT
Practice address
94 Locust Ave
Danbury, CT 06810-6032
Phone
(203) 830-3003
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1339 CT Primary

Addresses

Primary practice location

94 Locust Ave
Danbury, CT 06810-6032

Mailing address

84 Mountain Rd
Ridgefield, CT 06877-1611
Phone (203) 438-1422

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1912959164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 MOUNTAIN RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068771611",
            "telephone_number": "203-438-1422",
            "fax_number": "203-438-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 LOCUST AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106032",
            "telephone_number": "203-830-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABARES",
        "first_name": "MARA",
        "middle_name": "SUSSMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.