NPIMap

Organization Active NPI

Lawrence and Memorial Hospital, Inc.

Doing business as Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
National Provider Identifier
1073530879
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0047 Issued in CT
Legal business name
LAWRENCE AND MEMORIAL HOSPITAL, INC.
Doing business as
Lawrence and Memorial Hospital
Practice address
365 Montauk Avenue
New London, CT 06320
Phone
(860) 442-0711
NPI assigned
Jul 16, 2006
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Jacqueline Wrinn
Title
Director
Phone
(203) 688-8411

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0047 CT Primary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

365 Montauk Avenue
New London, CT 06320

Mailing address

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Other identifiers 14

IdentifierTypeStateIssuer
008OtherCTCT BLUE CROSS
004041679MedicaidCT
033921OtherHEALTHNET
XHSP31514MedicaidCA
97000007MedicaidNC
H04961OtherOXFORD
XHSP41514MedicaidCA
538520200MedicaidMN
9127OtherAETNA
946704OtherCONNECTICARE
7002688MedicaidMA
092591800MedicaidFL
004024972MedicaidCT
7201672MedicaidMA

Other names 1

  • Lawrence and Memorial Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429001142 CT Part B Supplier - Clinic/Group Practice 5991792053 Receives reassigned benefits from 101 practitioners
Practice locations: New London, CT
O20120313000737 CT Part A Provider - Hospital 5991792053 1 other NPI on this enrollment
Practice locations: Waterford, CT; New London, CT; Groton, CT; East Lyme, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073530879. Details of each certification follow.

Hospital certification: CCN 070007

Legal name
LAWRENCE AND MEMORIAL HOSPITAL INC.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 6, 2016
Beds
280
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
365 Montauk Ave
New London, CT 63204700
Other Hospital Practice Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Lawrence & Memorial HospitalCCN 070007 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

196 Parkway S
Waterford, CT 06385
Phone (860) 440-0688

11 Research Dr
Ste 1
Woodbridge, CT 06525

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Richard Lisitano Individual Corporate OfficerPresident Oct 1, 2023
William J Aseltyne Individual Corporate OfficerSecretary Oct 1, 2023
Jacqueline Wrinn Individual Corporate DirectorDir. Integrated Receivables MGMT Mar 1, 2025
W-2 Managing Employee Mar 1, 2025
Kathleen Holt Individual Corporate OfficerChariman Oct 1, 2023
Gail Kosyla Individual Corporate OfficerTreasurer Jan 1, 2025
Marie-Claire Peakman Individual Corporate OfficerVice Chair Oct 1, 2023

Practitioners & affiliated clinicians

Practitioners 117

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 117

Affiliated clinicians 1,097

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,097

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1073530879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVENUE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE AND MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "WRINN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-688-8411"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CT",
            "license": "0047",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT BLUE CROSS",
            "identifier": "008",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041679",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "033921",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP31514",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97000007",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "H04961",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP41514",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538520200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9127",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "946704",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002688",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092591800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004024972",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7201672",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lawrence and Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.