Stephen R Pedro, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001160 Issued in CT

Practice address

609 Farmington Ave
Suite 101
Hartford, CT 06105-3081

Phone

(860) 233-9922

Fax

(860) 233-2067

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Orthopedic and Sports Physical Therapy

  • Chiropractor
  • Hartford, CT
  • NPI 1386753176
  NPD (past) Authorized official
• West End Medical Group

  • Orthopaedic Surgery Physician
  • Hartford, CT
  • NPI 1750498549
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922115997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 FARMINGTON AVE",
            "address_2": "SUITE 101",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053081",
            "telephone_number": "860-233-9922",
            "fax_number": "860-233-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 FARMINGTON AVE",
            "address_2": "SUITE 101",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053081",
            "telephone_number": "860-233-9922",
            "fax_number": "860-233-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRO",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050001160CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Health Associates PC.
• Justin Matthew Pedneault, BSN, RN, CFRN, FP-C
• Kevin Louis Pedneault, PA-C
• Ronald Pedonti
• Pedro E. Segarra
• Samantha Gean Peek, APRN FNP-C
• Jennifer Ann Pelletier, A.P.R.N
• Lauren E Pelletier, MSW
• Samantha Alyssa Pelow, APRN
• Danielle Peltier

• Chiropractor in Hartford, CT
• Providers in Hartford, CT by specialty
• Chiropractor in Connecticut

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.