REX L MAHNENSMITH (NPI# 1760466528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760466528 |
Entity Type | Individual |
Full Name | REX L MAHNENSMITH |
Credential | M.D. |
Practice Address |
80 Phoenix Ave Waterbury CT 06702-1418 |
Practice Telephone | 2037568021 |
Practice Fax Number | 2035969038 |
Mailing Telephone | 2037568021 |
Mailing Fax Number | 2035969038 |
Enumeration Date | 2005-12-05 |
Last Update Date | 2015-10-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | 021731 | CT | Allopathic & Osteopathic Physicians |
N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
021731 | CT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 001217314 | 05 |
Street Address |
80 PHOENIX AVE |
City | WATERBURY |
State | CT |
Zip Code | 06702-1418 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497756902 | Michael Bass | Dentist | 80 Phoenix Ave, Suite #102, Waterbury, CT 06702-1418 | 2005-08-09 |
1356996920 | Raeven B Keene | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-08-09 |
1578022166 | Daedly Potusek | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-03-14 |
1598239873 | Ashley Corso | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-01-19 |
1326510801 | Monica Rose Depaolo | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2018-12-21 |
1023536232 | Courtney Dowen | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2017-09-07 |
1851834147 | Lindsey Maloney | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2016-11-18 |
1063864346 | Miguel Mantilla | Internal Medicine | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2016-07-11 |
1124477518 | George Gogas | Social Worker | 80 Phoenix Ave, Suite 201, Waterbury, CT 06702-1418 | 2016-06-07 |
1649626300 | Irene Maturo | Dental Hygienist | 80 Phoenix Ave, Suite 201, Waterbury, CT 06702-1418 | 2016-05-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
Find all providers in zip 06702 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
1053799544 | Emily Pinto Taylor | Internal Medicine | 133 Scovill St Ste 300, Waterbury, CT 06706-1127 | 2015-05-15 |
1578849519 | Uday Shankar | Internal Medicine | 3801 E Main St Fl 2, Waterbury, CT 06705 | 2011-10-21 |
1275828261 | Bechoi Saleib | Internal Medicine | 1981 E Main St, 2nd Floor, Waterbury, CT 06705-1822 | 2011-06-17 |
1750525549 | Benjamin Bodnar | Internal Medicine | 95 Scovill St Fl 3, Waterbury, CT 06706-1113 | 2009-04-24 |
1588848766 | Tracy Lyn Rabin | Internal Medicine | 64 Robbins Street, Waterbury Hospital Campus, Main 3, Yale Primary Care Program, Waterbury, CT 06708 | 2007-12-24 |
1255549622 | Ashish Arora | Internal Medicine | 133 Scovill St Ste 104, Waterbury, CT 06706-1127 | 2007-05-18 |
1780782953 | Vidya Loganathan | Internal Medicine | 2457 E Main St Ste 1e, Waterbury, CT 06705-2684 | 2006-09-20 |
1083724967 | Westside Medical Group | Internal Medicine | 714 Chase Parkway, Suite 6, Waterbury, CT 06708-3939 | 2006-08-30 |
1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
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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.