CT Integrated Pain Consultants, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

52543 Issued in CT

Legal business name

CT INTEGRATED PAIN CONSULTANTS, LLC

Practice address

125 Kings Hwy N
Lower Level
Westport, CT 06880-2428

Phone

(203) 815-9916

Fax

(203) 557-6688

NPI assigned

Feb 14, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Zhaodi Gong, MDNPI 1194977603

Title

Owner & Director

Phone

(203) 815-9916

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zhaodi Gong, MD, PHD

  • Pain Medicine (Anesthesiology) Physician
  • Westport, CT
  • NPI 1194977603
  Medicare reassignment NPD Authorized official
• Nellie Esther Rivera, LCSW

  • Clinical Social Worker
  • Norwalk, CT
  • NPI 1679742282
  NPD
• Rebecca Roessler Velasquez, LCSW

  • Clinical Social Worker
  • Norwalk, CT
  • NPI 1932447430
  NPD
• Deirdre Ann Ekholdt, LCSW

  • Clinical Social Worker
  • Bradenton, FL
  • NPI 1841562337
  NPD
• Angelica Fontanez, L.C.S.W.

  • Clinical Social Worker
  • Fairfield, CT
  • NPI 1710175161
  NPD (past)

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495756800000",
    "number": "1013456896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 COUNTRY CLUB DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252510",
            "telephone_number": "203-815-9916",
            "fax_number": "203-557-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KINGS HWY N",
            "address_2": "LOWER LEVEL",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802428",
            "telephone_number": "203-815-9916",
            "fax_number": "203-557-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT INTEGRATED PAIN CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-05-26",
        "status": "A",
        "authorized_official_last_name": "GONG",
        "authorized_official_first_name": "ZHAODI",
        "authorized_official_title_or_position": "OWNER & DIRECTOR",
        "authorized_official_telephone_number": "203-815-9916",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CT",
            "license": "52543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Crossfield, LMFT
• Alyssa Crouse
• Trevor Crow, MA, MFT
• Pamela W Crowcroft, CADC
• Katelyn Crowley, BCBA
• CT Sports Recovery PLLC
• Andrew S. Cummins
• Marta Monika Curry, PSY.D.
• Kyle Custis, M.D.
• Erica J Cywar, PHARMD

• Pain Medicine (Anesthesiology) Physician in Westport, CT
• Providers in Westport, CT by specialty
• Pain Medicine (Anesthesiology) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.