NPIMap

Organization Active NPI

Masonicare Health Center

  • Skilled Nursing Facility
  • Wallingford, CT
National Provider Identifier
1043690100
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10225 Issued in CT
Legal business name
MASONICARE HEALTH CENTER
Practice address
22 Masonic Ave
Wallingford, CT 06492-3048
Phone
(203) 679-5959
NPI assigned
Jun 4, 2015
Organization subpart
Yes
Parent organization
MASONICAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Audrey Webber, DPT
Title
PT
Phone
(203) 679-5959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10225 CT Primary

Addresses

Primary practice location

22 Masonic Ave
Wallingford, CT 06492-3048

Mailing address

22 Masonic Ave
Wallingford, CT 06492-3048

National Provider Directory

National Provider Directory
Tax ID family
Masonicare Health Center3 organizations share this tax ID, including this one
Part of
Opthalmology Department

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1043690100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-679-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONICARE HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MASONICARE",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "WEBBER",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "203-679-5959",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "10225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.