Active NPI
Patrick Sponzo
- Student in an Organized Health Care Education/Training Program
- Windsor, CT
National Provider Identifier
1093189136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 158696026
- Practice address
- 7 Sage Park Rd
Windsor, CT 06095-3327 - Phone
- (860) 707-4653
- NPI assigned
- Nov 29, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 158696026 | CT | Primary |
Addresses
Primary practice location
7 Sage Park Rd
Windsor, CT 06095-3327
Mailing address
7 Sage Park Rd
Windsor, CT 06095-3327
Phone (860) 707-4653
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 |
|---|---|---|---|
| 158696026 | CT | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448755200000",
"number": "1093189136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 SAGE PARK RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060953327",
"telephone_number": "860-707-4653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 SAGE PARK RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060953327",
"telephone_number": "860-707-4653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPONZO",
"first_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-29",
"last_updated": "2015-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "158696026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.