Active NPI
Douglas John De Massa, D.C.
- Nutrition Chiropractor
- Norwalk, CT
National Provider Identifier
1932312782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 001397
- Practice address
- 111 East Ave
Suite 336
Norwalk, CT 06851-5014 - Phone
- (203) 866-6000
- NPI assigned
- May 8, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 001397 | CT | Primary |
Addresses
Primary practice location
111 East Ave
Suite 336
Norwalk, CT 06851-5014
Mailing address
359 Bennetts Farm Rd
Ridgefield, CT 06877-2110
Phone (203) 894-8448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050001397CT01 | Other | CT | ANTHEM BLUE CARE PPO |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001397 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932312782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "359 BENNETTS FARM RD",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068772110",
"telephone_number": "203-894-8448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 EAST AVE",
"address_2": "SUITE 336",
"city": "NORWALK",
"state": "CT",
"postal_code": "068515014",
"telephone_number": "203-866-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MASSA",
"first_name": "DOUGLAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CT",
"license": "001397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CARE PPO",
"identifier": "050001397CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.