Individual provider Active NPI

Stacy T Unsworth, M.D.

  • Family Medicine Physician
  • Wallingford, CT
National Provider Identifier
1023020070
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
037727 Issued in CT
Practice address
950 Yale Ave
Wallingford, CT 06492-1858
Phone
(203) 265-9600
Fax
(203) 265-0580
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 037727 CT Primary

Addresses

Primary practice location

950 Yale Ave
Wallingford, CT 06492-1858

Mailing address

4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000877 CT Practitioner - Family Practice 8921139718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
037727CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family Medicine CurrentSince Sep 27, 1999 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

4 Farm Springs Rd
Farmington, CT 06032
Phone (860) 284-5200

950 Yale Ave
Wallingford, CT 06492
Phone (203) 265-9600

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023020070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-265-9600",
            "fax_number": "203-265-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNSWORTH",
        "first_name": "STACY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "037727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.