Organization Active NPI

Bavaro Chiropractic Center, LLC

  • Chiropractor
  • Woodbury, CT
National Provider Identifier
1962690834
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
832 Issued in CT
Legal business name
BAVARO CHIROPRACTIC CENTER, LLC
Practice address
2 White Oak Rd
Woodbury, CT 06798-2832
Phone
(203) 263-2720
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Karen Bavaro, DC
Title
President
Phone
(203) 263-2720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 832 CT Primary

Addresses

Primary practice location

2 White Oak Rd
Woodbury, CT 06798-2832

Mailing address

2 White Oak Rd
Woodbury, CT 06798-2832
Phone (203) 263-2720

Other identifiers 1

IdentifierTypeStateIssuer
004122991MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826000738 CT Part B Supplier - Clinic/Group Practice 7618942467 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, 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": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1962690834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WHITE OAK RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982832",
            "telephone_number": "203-263-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WHITE OAK RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982832",
            "telephone_number": "203-263-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAVARO CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "BAVARO",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-263-2720",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004122991",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.