BRISTOL HOSPITAL MULTI-SPECIALTY GROUP, INC. (NPI# 1396734109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396734109 |
| Entity Type | Organization |
| Organization Name | BRISTOL HOSPITAL MULTI-SPECIALTY GROUP, INC. |
| Practice Address |
10 N Main St Suite 210 Bristol CT 06010-8122 |
| Mailing Address |
Po Box 2828 Bristol CT 06011-2828 |
| Practice Telephone | 8603142052 |
| Practice Fax Number | 8603142054 |
| Mailing Telephone | 8605853906 |
| Mailing Fax Number | 8605853907 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2011-08-25 |
| Authorized Official Name | LEONARD BANCO (VICE PRESIDENT) |
| Authorized Official Telephone | 8605853528 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004212982 | 05 | |
| CT | 004262804 | 05 | |
| CT | 004188985 | 05 | |
| CT | 004253291 | 05 | |
| CT | 004255445 | 05 | |
| CT | 004194130 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649265679 | Bristol Hospital Multi-specialty Group, Inc. | Clinic/Center | 923 Farmington Ave, Bristol, CT 06010-3927 | 2005-09-15 |
| 1154625374 | Bristol Hospital Multi-specialty Group, Inc. | Surgery | 25 Newell Rd, Suite D25, Bristol, CT 06010-5100 | 2011-01-03 |
| 1609084581 | Bristol Hospital Multi-specialty Group, Inc. | Obstetrics & Gynecology | 44 Brewster Road, Bristol, CT 06010-2828 | 2007-05-21 |
| 1043429806 | Bristol Hospital Multi-specialty Group, Inc. | Pediatrics | 44 Brewster Road, Bristol, CT 06010 | 2007-05-21 |
| Street Address |
10 N MAIN ST SUITE 210 |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010-8122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815782 | Khushboo Surti | Nurse Practitioner | 10 N Main St, Bristol, CT 06010-8122 | 2020-09-09 |
| 1124638481 | Shannon Rebecca Walsh | Social Worker | 10 N Main St, Bristol, CT 06010-8122 | 2020-08-03 |
| 1396381448 | Wheeler Clinic Inc. | Clinic/Center | 10 N Main St, Bristol, CT 06010-8122 | 2019-11-25 |
| 1538700042 | Helen Margaret Nutt | Nurse Practitioner | 10 N Main St, Bristol, CT 06010-8122 | 2019-10-06 |
| 1578118162 | Kelli Ann Klies | Registered Nurse | 10 N Main St, Bristol, CT 06010-8122 | 2019-08-09 |
| 1750850467 | Julio Angel Sanchez | Registered Nurse | 10 N Main St, Bristol, CT 06010-8122 | 2018-11-26 |
| 1841773959 | Lisa Marie Roth | Case Manager/Care Coordinator | 10 N Main St, Bristol, CT 06010-8122 | 2018-09-13 |
| 1144709585 | Adilsa R Encarnacao | Social Worker | 10 N Main St, Bristol, CT 06010-8122 | 2018-08-07 |
| 1114415007 | Germaine Michele Andrews | Registered Nurse | 10 N Main St, Bristol, CT 06010-8122 | 2018-04-25 |
| 1548760119 | Wheeler Clinic Inc. | Clinic/Center | 10 N Main St, Bristol, CT 06010-8122 | 2018-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457991309 | A New Hope Caregiving Alliance LLC | Home Health | 225 North Main Street - Suite 107, Bristol, CT 06010 | 2020-01-08 |
| 1154981777 | Georgianna Sloate Lmft, LLC | Marriage & Family Therapist | 38 Kelley Street, Bristol, CT 06010 | 2019-06-17 |
| 1962062810 | Ariel Morley | Urology | 15 Riverside Avenue, Bristol, CT 06010 | 2019-06-13 |
| 1013439488 | Theresa Rose Manolitsis | Student in an Organized Health Care Education/Training Program | 170 Pondview Lane, Bristol, CT 06010 | 2017-07-07 |
| 1588103600 | Elizabeth Anne Costello | Pharmacist | 747 Pine Street, Bristol, CT 06010 | 2017-02-22 |
| 1992157903 | Aiman Riaz | Internal Medicine | 41 Brewster Rd # 5161, Bristol, CT 06010 | 2016-07-01 |
| 1346609955 | Monika Magdalena Sullivan | Nurse Practitioner | 122 Maple Street, Bristol, CT 06010 | 2016-02-11 |
| 1346660776 | Peter Bellezza | Podiatrist | 15 Riverside Ave, Bristol, CT 06010 | 2014-04-24 |
| 1487088001 | Stephen Alexander Merwin | Social Worker | 32 Laird Drive, Bristol, CT 06010 | 2013-08-30 |
| 1215369574 | In Kyung Lee | Dentist | 1192 Farmington Ave., Bristol, CT 06010 | 2013-08-08 |
| Find all providers in zip 06010 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619470655 | Becky Kreuzer Aprn, Pmhnp, LLC | Psychiatry & Neurology | 22 Pine St Ste 205, Bristol, CT 06010-6949 | 2018-03-15 |
| 1609263516 | Katrina Shchupak | Psychiatry & Neurology | 499 Bath Rd, Bristol, PA 19007 | 2015-04-17 |
| 1366641839 | Jeffrey T Shelton | Psychiatry & Neurology | 440 N Main St Ste C, Upper Level, Bristol, CT 06010-1902 | 2007-07-16 |
| 1851406383 | Diane E Hawkins | Psychiatry & Neurology | 510 Cumberland Street, Executive Plaza 4th Floor, Bristol, VA 24201 | 2006-08-21 |
| 1881661627 | Safia M Sabri | Psychiatry & Neurology | One Medical Park Blve., Bristol, TN 37620 | 2006-03-01 |
| 1134117492 | Frederick O Reindel | Psychiatry & Neurology | 10 N Main St Ste 210, Bristol, CT 06010-8122 | 2005-10-11 |
| 1972070530 | Integral Mental Mental Health Services LLC | Psychiatry & Neurology | 226 Mill St, Bristol, PA 19007-4809 | 2018-10-31 |
| 1326386475 | Angelo De Los Angeles | Psychiatry & Neurology | 41 Brewster Rd, Bristol Hospital, Bristol, CT 06010-5161 | 2013-01-24 |
| 1548589203 | Ranjan K Sinha Md PC | Psychiatry & Neurology | 501 Bath Rd, Bristol, PA 19007-3101 | 2010-05-20 |
| 1891956827 | Genevieve Armstrong Henry | Psychiatry & Neurology | 41 Brewster Rd, Bristol, CT 06010-5161 | 2008-06-23 |
| Find all providers in BRISTOL | ||||
Please comment or provide details below to improve the information on BRISTOL HOSPITAL MULTI-SPECIALTY GROUP, INC..
| 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.