The Modern Doctor LLC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

000591 Issued in CT

Legal business name

THE MODERN DOCTOR LLC

Practice address

460 Huntington St
Shelton, CT 06484-4620

Phone

(203) 521-2620

NPI assigned

May 11, 2017

Last updated

May 11, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon Homkovics, N.D.NPI 1972049625

Title

Doctor

Phone

(203) 521-2620

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Homkovics, N.D.

  • Naturopath
  • Shelton, CT
  • NPI 1972049625
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1013443860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HUNTINGTON ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844620",
            "telephone_number": "203-521-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HUNTINGTON ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844620",
            "telephone_number": "203-521-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MODERN DOCTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "HOMKOVICS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "203-521-2620",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CT",
            "license": "000591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Shelton, CT
• Providers in Shelton, CT by specialty
• Naturopath in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.