Individual provider Active NPI

Jessica Elizabeth Mackenzie, D.C

  • Chiropractor
  • New Britain, CT
National Provider Identifier
1942387675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1362 Issued in CT
Practice address
25 Court St
New Britain, CT 06051-2211
Phone
(860) 229-1490
Fax
(860) 223-0468
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1362 CT Primary

Addresses

Primary practice location

25 Court St
New Britain, CT 06051-2211

Mailing address

21 Angela Dr
Wallingford, CT 06492-1779
Phone (203) 265-4945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000334 CT Practitioner - Chiropractic 3072656115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1224 Farmington Ave
West Hartford, CT 06107-2668
Phone (860) 760-0342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001362CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mackenzie Chiropractic, LLC Chiropractor CurrentSince Apr 30, 2003 Accepting new patients

Locations

1224 Farmington Ave
West Hartford, CT 06107
Phone (860) 558-7800

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942387675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ANGELA DR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921779",
            "telephone_number": "203-265-4945",
            "fax_number": "860-223-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COURT ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060512211",
            "telephone_number": "860-229-1490",
            "fax_number": "860-223-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, 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.

Verify at the official NPI Registry.