BACKUS PHYSICIAN SERVICES, LLC (NPI# 1174782767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174782767 |
| Entity Type | Organization |
| Organization Name | BACKUS PHYSICIAN SERVICES, LLC |
| Practice Address |
12 Case St Suite 313 Norwich CT 06360-2222 |
| Mailing Address |
112 Lafayette St Norwich CT 06360-2737 |
| Practice Telephone | 8602049126 |
| Practice Fax Number | 8602049146 |
| Mailing Telephone | 8604258715 |
| Mailing Fax Number | 8604258707 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2012-10-04 |
| Authorized Official Name | DANIEL LOHR (VICE PRESIDENT) |
| Authorized Official Telephone | 8608898331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208C00000X | Colon & Rectal Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 174400000X | Specialist | Other Service Providers | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12 CASE ST SUITE 313 |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871598649 | Mahesh Narayan Kabadi | Internal Medicine | 12 Case St, Ste 102, Norwich, CT 06360-2222 | 2005-06-16 |
| 1831564160 | Amy Masse | Clinical Neuropsychologist | 12 Case St, Suite 301, Norwich, CT 06360-2222 | 2015-12-12 |
| 1790199784 | Ct Psychological Associates | Clinical Neuropsychologist | 12 Case St, Suite 301, Norwich, CT 06360-2222 | 2014-06-17 |
| 1942578778 | Eastern Connecticut Psychological Associates, LLC | Clinic/Center | 12 Case St, Suite 202, Norwich, CT 06360-2222 | 2011-12-07 |
| 1942584636 | Stephanie Malia | Nurse Practitioner | 12 Case St, Suite 213, Norwich, CT 06360-2222 | 2011-09-29 |
| 1609173160 | Advanced Community Support, LLC | Home Health | 12 Case St, Suite 206, Norwich, CT 06360-2222 | 2011-02-18 |
| 1558664839 | Rita Cecile Ammons | Massage Therapist | 12 Case St, Suite 306, Norwich, CT 06360-2222 | 2010-12-08 |
| 1730333998 | Deborah M. Zlatin | Social Worker | 12 Case St, Suite 301, Norwich, CT 06360-2222 | 2008-11-13 |
| 1942467352 | Christy Ann Stanat | Surgery | 12 Case St, Norwich, CT 06360-2222 | 2008-05-22 |
| 1659584290 | Recovery Resources, LLC | Home Health | 12 Case St, Suite 205, Norwich, CT 06360-2222 | 2007-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154763027 | James Matthew Herzog | Specialist | 109 Thompson Creek Rd, Norwich, NY 13815-3543 | 2013-07-22 |
| 1144584459 | Mary Carson | Specialist | 79 S Broad St, Norwich, NY 13815-1741 | 2012-07-02 |
| 1013278175 | Dawn S Hagenbuch | Specialist | 5456 State Highway 23, Norwich, NY 13815-3142 | 2012-06-06 |
| 1568474484 | Steven K Gamble | Specialist | 7 Clinic Drive, Norwich, CT 06360-2915 | 2006-08-12 |
| 1396701256 | Robert - Kerrigan | Specialist | 60 Mediterranean Ln, Norwich, CT 06360-1648 | 2006-04-20 |
| 1821064379 | Norwich Pathology Consultants, P.C. | Specialist | 120 Lafayette St, Suite 213, Norwich, CT 06360-2717 | 2006-02-24 |
| 1992784797 | Seco Physical & Occupational Therapy Pllc | Specialist | 6110 Co Rt 32, Norwich, NY 13815-1046 | 2006-01-11 |
| 1427485499 | Kim Mauro | Specialist | 7 Clinic Dr, Norwich, CT 06360-2915 | 2013-10-04 |
| 1346578978 | K Stephens Taylor Md PC | Specialist | 57 Lafayette St, Norwich, CT 06360-3407 | 2009-11-19 |
| 1730332313 | Norwich Infectious Disease Associates LLC | Specialist | 112 Lafayette St, Norwich, CT 06360-2737 | 2008-10-28 |
| Find all providers in NORWICH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.