NPIMap

Organization Active NPI

Visiting Nurse Association of Wallingford, Inc.

  • Clinical Social Worker
  • Wallingford, CT
National Provider Identifier
1083927164
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
VISITING NURSE ASSOCIATION OF WALLINGFORD, INC.
Practice address
135 N Plains Industrial Rd
Wallingford, CT 06492-2332
Phone
(203) 269-1475
Fax
(203) 265-5357
NPI assigned
Jul 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Ms. Ellen S. Phillips, MSW
Title
Executive Director
Phone
(203) 269-1475

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CT

Addresses

Primary practice location

135 N Plains Industrial Rd
Wallingford, CT 06492-2332

Mailing address

135 N Plains Industrial Rd
Wallingford, CT 06492-2332
Phone (203) 269-1475

Other identifiers 1

IdentifierTypeStateIssuer
4042800MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
Visiting Nurse Association of Wallingford Inc3 organizations share this tax ID, including this one

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": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1083927164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N PLAINS INDUSTRIAL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922332",
            "telephone_number": "203-269-1475",
            "fax_number": "203-265-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N PLAINS INDUSTRIAL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922332",
            "telephone_number": "203-269-1475",
            "fax_number": "203-265-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE ASSOCIATION OF WALLINGFORD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "203-269-1475",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4042800",
            "state": "CT"
        }
    ],
    "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 Oct 4, 2011; 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.