Active NPI
David Dawiczyk
- In Home Supportive Care Agency
- Bristol, CT
National Provider Identifier
1083963540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- HCA.0000461
- Practice address
- 22 Pine St Ste 213
Bristol, CT 06010-6950 - Phone
- (860) 261-4405
- Fax
- (860) 261-4265
- NPI assigned
- Aug 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | HCA.0000461 | CT | Primary |
Addresses
Primary practice location
22 Pine St Ste 213
Bristol, CT 06010-6950
Mailing address
22 Pine St Ste 213
Bristol, CT 06010-6950
Phone (860) 261-4405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HCA.0000461 | CT | MD | In Home Supportive Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Always Best Care of Greater Bristol | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Bristol, CT
- NPI 1811490048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346284800000",
"number": "1083963540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PINE ST STE 213",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060106950",
"telephone_number": "860-261-4405",
"fax_number": "860-261-4625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 PINE ST STE 213",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060106950",
"telephone_number": "860-261-4405",
"fax_number": "860-261-4265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWICZYK",
"first_name": "DAVID",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-30",
"last_updated": "2012-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "CT",
"license": "HCA.0000461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.