STATE OF CONNECTICUT (NPI# 1669466561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669466561 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT |
| Other Organization Name | JOHN DEMPSEY HOSPITAL |
| Practice Address |
263 Farmington Avenue Farmington CT 06030-5355 |
| Practice Telephone | 8606792916 |
| Practice Fax Number | 8606793071 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2013-11-15 |
| Authorized Official Name | MR. JOHN BIANCAMANO (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8606791145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
00065 | CT | Ambulatory Health Care Facilities |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
00065 | CT | Behavioral Health & Social Service Providers |
| N | 207P00000X | Emergency Medicine | CT | Allopathic & Osteopathic Physicians | |
| N | 101YP2500X |
Counselor Specialization: Professional |
00065 | CT | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 00065 | CT | Behavioral Health & Social Service Providers |
| Y | 282N00000X | General Acute Care Hospital | 00065 | CT | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 4041968 | 05 |
| Other Name | Type Code |
|---|---|
| John Dempsey Hospital | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871095851 | State of Connecticut | Clinic/Center | 850 Bolton Rd Unit 1271, Storrs, CT 06269-1271 | 2018-03-06 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1790974657 | State of Connecticut | Durable Medical Equipment & Medical Supplies | 381 Hopmeadow Street, Simsbury, CT 06070 | 2007-10-17 |
| 1205951662 | State of Connecticut | Skilled Nursing Facility | 287 West Street, Rocky Hill, CT 06067-3904 | 2007-03-21 |
| 1750459855 | State of Connecticut | Psychiatric Residential Treatment Facility | 915 River Road, Middletown, CT 06457-3921 | 2006-11-30 |
| 1427074426 | State of Connecticut | Clinic/Center | Silver Street, Dutton Home, Middletown, CT 06457 | 2006-07-14 |
| 1366477903 | State of Connecticut | Psychiatric Hospital | 525 Russell Rd, Newington, CT 06111 | 2006-07-12 |
| 1487689022 | State of Connecticut | Clinic/Center | 500 Vine Street, Hartford, CT 06112 | 2006-07-12 |
| 1841225489 | State of Connecticut | Clinic/Center | 55 West Main Street, Suite 410 Rowland State Government Center, Waterbury, CT 06702 | 2006-07-12 |
| 1225063860 | State of Connecticut | Clinic/Center | 2 Vance Drive Russell Hall, Connecticut Valley Hospital, Middletown, CT 06457 | 2006-07-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF CONNECTICUT DMR | 460 Capitol Ave, Hartford, CT 06106-1308 |
| Street Address |
263 FARMINGTON AVENUE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-5355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619584026 | Sylvia Polanco | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030-8203 | 2020-09-29 |
| 1154930956 | Lindsay Allison Petriello | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030 | 2020-07-28 |
| 1891304663 | Kara Dazkevich | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030-0001 | 2020-07-28 |
| 1093324873 | Kaitlin Jeanne O'connor | Nurse Practitioner | 263 Farmington Avenue, Icu, University Tower, 1st Floor, Mail Code: 1131, Farmington, CT 06030 | 2020-07-28 |
| 1457975070 | Shriya Gupta | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Uconn Health - Outpatient Pavilion, Farmington, CT 06030-8031 | 2020-05-29 |
| 1114540150 | Carolina Mendes Pessoa | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, 2 West Uconn Clinic, Internal Medicine Associates, Ou, Farmington, CT 06032 | 2020-05-26 |
| 1457971293 | Christopher Dalton Lemoine | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-8073 | 2020-04-22 |
| 1871112953 | Cory Hewitt | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-4037 | 2020-04-09 |
| 1154940310 | Jeffrey Henry | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-1930 | 2020-04-08 |
| 1457980070 | Jennifer Hale | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-8073 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617606 | David Wozny | Student in an Organized Health Care Education/Training Program | General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-13 |
| 1508495185 | Zachary Boivin | Student in an Organized Health Care Education/Training Program | Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-06 |
| 1063903730 | Agura Afiari | Student in an Organized Health Care Education/Training Program | Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 | 2018-05-29 |
| 1750879474 | Areeba Siddiqui | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue Mc1921, Farmington, CT 06030 | 2018-04-27 |
| 1508362013 | Arya Saniee I | Student in an Organized Health Care Education/Training Program | 264 Farmington Ave, Farmington, CT 06030 | 2018-04-03 |
| 1679828594 | Randall Morera | Student in an Organized Health Care Education/Training Program | 262 Farmington Ave, Farmington, CT 06030 | 2012-07-17 |
| 1750644365 | Ugonna Ijeoma | Student in an Organized Health Care Education/Training Program | 260 Farmington Ave, Farmington, CT 06030 | 2012-06-19 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1851456495 | Jeffrey Gross | Anesthesiology | 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 | 2006-12-26 |
| 1649225269 | Julian Nieves | Internal Medicine | 263 Famrington Avenue, Farmington, CT 06030 | 2006-05-23 |
| Find all providers in zip 06030 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225415417 | Parkland Veterinary Services, Inc. | General Acute Care Hospital | 615 E Karsch Blvd, Farmington, MO 63640-1225 | 2015-04-27 |
| 1932369907 | University of Connecticut Health Center | General Acute Care Hospital | 263 Farmington Ave # Mc-1119, Farmington, CT 06030-0001 | 2008-06-13 |
| 1962431791 | The Center for Advanced Reproductive Services, P.c | General Acute Care Hospital | 877 Plainville Ave, Farmington, CT 06032-3121 | 2006-07-02 |
| 1609356419 | Mainehealth | General Acute Care Hospital | 111 Franklin Health Cmns, Farmington, ME 04938-6144 | 2018-08-21 |
| 1568994713 | Uconn | General Acute Care Hospital | 263 Farmington Ave, Uconn, Farmington, CT 06030-0001 | 2017-03-28 |
| 1285080648 | Uconn Health | General Acute Care Hospital | 263 Farmington Ave, Farmington, CT 06030-0001 | 2016-05-04 |
| 1750776365 | Parkland Health Center - Weber Road | General Acute Care Hospital | 1212 Weber Rd, Farmington, MO 63640-3325 | 2015-03-31 |
| 1346651015 | University of Connecticut Health Center | General Acute Care Hospital | 263 Farmington Ave, Farmington, CT 06030-1720 | 2014-05-15 |
| 1215363700 | Capital Area Health Consortium | General Acute Care Hospital | 263 Farmington Ave, Farmington, CT 06030-0001 | 2013-09-17 |
| 1760821896 | Uconn Correctional Managed Healthcare | General Acute Care Hospital | 263 Farmington Ave, Farmington, CT 06032-1956 | 2013-06-21 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 06030 |
Please comment or provide details below to improve the information on STATE OF CONNECTICUT.
| 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.