STAYWELL HEALTH CARE, INC. (NPI# 1932355567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932355567 |
| Entity Type | Organization |
| Organization Name | STAYWELL HEALTH CARE, INC. |
| Other Organization Name | STAYWELL SOUTH MAIN |
| Practice Address |
1302 S Main St Waterbury CT 06706-1748 |
| Mailing Address |
80 Phoenix Ave Ste 201 Waterbury CT 06702-1418 |
| Practice Telephone | 2037568021 |
| Practice Fax Number | 2035969038 |
| Mailing Telephone | 2037568021 |
| Mailing Fax Number | 2035969038 |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2018-02-08 |
| Authorized Official Name | MR. DONALD THOMPSON (PRESIDENT) |
| Authorized Official Telephone | 2037568021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0360 | CT | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Staywell South Main | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033366240 | Staywell Health Care, Inc. | Clinic/Center | 95 Thomaston Ave, Waterbury, CT 06702-1007 | 2008-08-20 |
| 1154342335 | Staywell Health Care, Inc. | Pediatrics | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2006-07-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STAYWELL HEALTH CARE, INC. | 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418 |
| Connecticut Business Registrations | STAYWELL HEALTH CARE, INC. | 80 Phoenix Avenue, Suite 201, Waterbury, CT 06702 |
| Street Address |
1302 S MAIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780685610 | Paula Magalhaes Coelho | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2005-08-02 |
| 1568017671 | Debora Rocha Donascimento-silva | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2019-08-06 |
| 1427530575 | Amy L Backstrom | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2018-09-05 |
| 1083101349 | Karen Cooper-tripp | Registered Nurse | 1302 S Main St, Waterbury, CT 06706-1748 | 2018-04-21 |
| 1033647243 | Ezequiel Alvarez-figueroa | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2017-06-01 |
| 1972044832 | Angel M. Laplante | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2017-03-12 |
| 1033580337 | Sonila Alickolli | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2015-10-13 |
| 1316333990 | Monika Mishra | Internal Medicine | 1302 S Main St, Waterbury, CT 06706-1748 | 2015-04-10 |
| 1184978173 | Brittny Ann Sciarra | Dental Hygienist | 1302 S Main St, Waterbury, CT 06706-1748 | 2012-10-30 |
| 1316002082 | Steven Michael Baltrush | Social Worker | 1302 S Main St, Waterbury, CT 06706-1748 | 2006-12-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1013455351 | Denisse Burgos-jimenez | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2017-02-07 |
| 1902255086 | Kaitlyn Jennings | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2016-06-08 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| Find all providers in zip 06706 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679108492 | Sky Health Group PC | Family Medicine | 64 Blue Ridge Drive, Waterbury, CT 06704 | 2020-03-12 |
| 1629113386 | Elizabeth Sosna White | Family Medicine | 93 Pilgrim Park Rd, Suite 6, Waterbury, VT 05676-1727 | 2007-02-20 |
| 1144270588 | Diane Swensen Miller | Family Medicine | 2457 E. Main St., Waterbury, CT 06705 | 2006-05-10 |
| 1396218293 | Cityblock Medical Practice Ct, P.C. | Family Medicine | 76 Center St Fl 3, Waterbury, CT 06702-2129 | 2019-01-03 |
| 1215403068 | Alison Chick | Family Medicine | 130 S Main St, Waterbury, VT 05676-1519 | 2018-10-19 |
| 1619407780 | Xi Teng | Family Medicine | 51 N Elm St, Waterbury, CT 06702-1545 | 2017-06-12 |
| 1386175644 | Peter James Ireland | Family Medicine | 130 S Main St, Waterbury, VT 05676-1519 | 2017-03-27 |
| 1992144190 | Nnennaya Duke | Family Medicine | 51 N Elm St, Waterbury, CT 06702-1545 | 2013-06-20 |
| 1922253483 | Sarah Faith Walsh | Family Medicine | 2247 E Main St, Suite 103, Waterbury, CT 06705-2604 | 2008-11-25 |
| 1275651549 | Justin Karlitz-grodin | Family Medicine | 130 S Main St, Cvmc Family Medicine-watebury, Waterbury, VT 05676-1519 | 2007-03-26 |
| Find all providers in WATERBURY | ||||
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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.