Organization Active NPI

Greater Danbury Pain Center PC

  • Chiropractor
  • Brookfield, CT
National Provider Identifier
1962543207
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001284 Issued in CT
Legal business name
GREATER DANBURY PAIN CENTER PC
Practice address
247 Federal Rd
Brookfield, CT 06804-2630
Phone
(203) 775-5003
Fax
(203) 740-8029
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Dr. Roger Roughley, DCNPI 1417184896
Title
President
Phone
(203) 775-5003

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 001284 CT Primary

Addresses

Primary practice location

247 Federal Rd
Brookfield, CT 06804-2630

Mailing address

247 Federal Rd
Brookfield, CT 06804-2630
Phone (203) 775-5003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090619000438 CT Part B Supplier - Clinic/Group Practice 8921159674 Receives reassigned benefits from 1 practitioner
Practice locations: Brookfield, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1962543207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042630",
            "telephone_number": "203-775-5003",
            "fax_number": "203-740-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042630",
            "telephone_number": "203-775-5003",
            "fax_number": "203-740-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER DANBURY PAIN CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "ROUGHLEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-775-5003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.