NPIMap

Organization Active NPI

Larry Bilker, PH.D., LLC

  • Psychologist
  • Guilford, CT
National Provider Identifier
1053615534
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
LARRY BILKER, PH.D., LLC
Practice address
296 Valley Shore Dr
Guilford, CT 06437-2147
Phone
(203) 453-4446
NPI assigned
Dec 27, 2010
Last updated
Dec 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Mr. Larry BilkerNPI 1013943695
Title
Member
Phone
(202) 453-4446

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

296 Valley Shore Dr
Guilford, CT 06437-2147

Mailing address

296 Valley Shore Dr
Guilford, CT 06437-2147
Phone (203) 453-4446

Other identifiers 1

IdentifierTypeStateIssuer
004051918MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130904000128 CT Part B Supplier - Clinic/Group Practice 3375786726 Receives reassigned benefits from 1 practitioner
Practice locations: Guilford, CT; New Haven, CT

National Provider Directory

National Provider Directory

Locations

175 Copse Rd
Madison, CT 06443
Phone (203) 245-2778

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1053615534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 VALLEY SHORE DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372147",
            "telephone_number": "203-453-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 VALLEY SHORE DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372147",
            "telephone_number": "203-453-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY BILKER, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "BILKER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "202-453-4446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004051918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.