ELLIS MEDICAL CENTER, LLC (NPI# 1740424969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740424969 |
| Entity Type | Organization |
| Organization Name | ELLIS MEDICAL CENTER, LLC |
| Practice Address |
701 Cottage Grove Rd Bloomfield CT 06002-3080 |
| Practice Telephone | 8602431864 |
| Mailing Telephone | 8602431864 |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-05-01 |
| Authorized Official Name | DR. LENWORTH ELLIS (MANAGING MEMBER) |
| Authorized Official Telephone | 8602431864 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
041803 | CT | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346484672 | Ellis Medical Center, LLC | Clinic/Center | 701 Cottage Grove Rd, Suite A110, Bloomfield, CT 06002-3080 | 2009-04-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | ELLIS MEDICAL CENTER, LLC | 701 Cottage Grove, Suite A110, Bloomfield, CT 06085 |
| Street Address |
701 COTTAGE GROVE RD |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-3080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356346779 | David Allen Feingold | Physical Medicine & Rehabilitation | 701 Cottage Grove Rd, Ste F120, Bloomfield, CT 06002-3095 | 2005-06-14 |
| 1386101954 | Anastasia Climan | Dietitian, Registered | 701 Cottage Grove Rd, Bloomfield, CT 06002-3080 | 2019-03-01 |
| 1730571282 | Thomas O'connor, Md, LLC | Clinic/Center | 701 Cottage Grove Rd, Ste A210, Bloomfield, CT 06002-3080 | 2015-02-20 |
| 1093115057 | Daniela Shvetsov | Physician Assistant | 701 Cottage Grove Rd, Suite E210, Bloomfield, CT 06002-3080 | 2014-08-27 |
| 1528408663 | Propicius Brain & Spine LLC | Specialist | 701 Cottage Grove Rd, Ste. E230, Bloomfield, CT 06002-3080 | 2013-07-03 |
| 1386998649 | David B Shamash | Dentist | 701 Cottage Grove Rd, Suite F210, Bloomfield, CT 06002-3080 | 2012-11-07 |
| 1104192921 | Md Care Psychiatric Services LLC | Psychiatry & Neurology | 701 Cottage Grove Rd, Suite B230, Bloomfield, CT 06002-3079 | 2012-03-26 |
| 1841581402 | Robert D. Rudnicki M.d., P.C. | Internal Medicine | 701 Cottage Grove Rd, Suite C-230, Bloomfield, CT 06002-3080 | 2011-04-29 |
| 1053612150 | Reflections Psychotherapy Services LLC | Community/Behavioral Health | 701 Cottage Grove Rd, Suite F 120, Bloomfield, CT 06002 | 2010-11-06 |
| 1669792354 | Arzu I. Demirci | Internal Medicine | 701 Cottage Grove Rd, Suite E210, Bloomfield, CT 06002-3080 | 2010-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| Taxonomy Code | 261QX0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Occupational Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003280397 | Medworks, LLC | Clinic/Center | 375 E Cedar St, Newington, CT 06111-1528 | 2015-11-24 |
| 1922556547 | Connecticut Orthopaedic Specialists, PC | Clinic/Center | 2416 Whitney Ave, Occnow, Hamden, CT 06518-3248 | 2016-09-12 |
| 1134468143 | General Dynamics | Clinic/Center | 75 Eastern Point Rd, Groton, CT 06340-4905 | 2013-02-11 |
| 1295071942 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 967 Parker St, Manchester, CT 06042-2208 | 2012-12-28 |
| 1376815274 | The Hospital of Saint Raphael | Clinic/Center | 175 Sherman Ave, 5th Fl., New Haven, CT 06511-4357 | 2012-02-08 |
| 1962731869 | New Britain Occupational Health | Clinic/Center | 440 New Britain Ave, Plainville, CT 06062-2036 | 2009-12-24 |
| 1700019932 | United Methodist Home of Sharon | Clinic/Center | 27 Hospital Hill Rd, Sharon, CT 06069 | 2009-09-04 |
| 1366680548 | Echn Johnson Health Care, Inc. | Clinic/Center | 3 Weymouth Rd, Enfield, CT 06083-1153 | 2009-01-27 |
| 1740314061 | Johnson Occupational Medicine Center | Clinic/Center | 3 Weymouth Rd, Enfield, CT 06083-1153 | 2007-03-16 |
| City | BLOOMFIELD |
| Zip Code | 06002 |
Please comment or provide details below to improve the information on ELLIS MEDICAL CENTER, LLC.
| 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.