NPIMap

Organization Active NPI

Day Kimball Hospital of Windham County

Doing business as Day Kimball Hospital Physician Practices

  • Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1053695452
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DAY KIMBALL HOSPITAL OF WINDHAM COUNTY
Doing business as
Day Kimball Hospital Physician Practices
Practice address
320 Pomfret St
Putnam, CT 06260-1836
Phone
(860) 928-6541
Fax
(860) 963-6450
NPI assigned
Oct 4, 2011
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DAY KIMBALL HOSPITAL OF WHINDHAM COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Mr. Kyle Kramer
Title
Ceo
Phone
(860) 928-6541

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Nurse Practitioner 363L00000X NU Primary
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU
Gerontology Nurse Practitioner 363LG0600X NU
Pediatric Nurse Practitioner 363LP0200X NU
Primary Care Nurse Practitioner 363LP2300X NU
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X NU

Addresses

Primary practice location

320 Pomfret St
Putnam, CT 06260-1836

Mailing address

320 Pomfret St
Suite CSB2
Putnam, CT 06260-1836
Phone (860) 928-6541

Other identifiers 1

IdentifierTypeStateIssuer
004024931MedicaidCT

Other names 1

  • DAY KIMBALL HOSPITAL PHYSICIAN PRACTICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ronald Soucier D O12 organizations share this tax ID, including this one
Part of
Ronald Soucier D O

Other organizations with this tax ID 11

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": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1053695452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "address_2": "SUITE CSB2",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAY KIMBALL HOSPITAL OF WINDHAM COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAY KIMBALL HOSPITAL OF WHINDHAM COUNTY",
        "enumeration_date": "2011-10-04",
        "last_updated": "2021-04-21",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-928-6541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004024931",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAY KIMBALL HOSPITAL PHYSICIAN PRACTICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DAY KIMBALL HOSPITAL PHYSICIAN PRACTICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Putnam, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.