Active NPI
Neurological Group, PC
- Family Nurse Practitioner
- New London, CT
National Provider Identifier
1114120698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 003504
- Legal business name
- NEUROLOGICAL GROUP, PC
- Practice address
- 350 Montauk Ave
New London, CT 06320-4730 - Phone
- (860) 443-1891
- Fax
- (860) 443-2980
- NPI assigned
- Jun 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rosemary Stephenson
- Title
- Office Manager
- Phone
- (860) 443-1891
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 003504 | CT | Primary |
Addresses
Primary practice location
350 Montauk Ave
New London, CT 06320-4730
Mailing address
350 Montauk Ave
New London, CT 06320-4730
Phone (860) 443-1891
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003504 | Other | CT | STATE LICENSE |
National Provider Directory
National Provider Directory- Tax ID family
- Neurological Group PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Health Nurse Practitioner
- New London, CT
- NPI 1205378163
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- New London, CT
- NPI 1508860156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1114120698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204730",
"telephone_number": "860-443-1891",
"fax_number": "860-443-2980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204730",
"telephone_number": "860-443-1891",
"fax_number": "860-443-2980"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEUROLOGICAL GROUP, PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "STEPHENSON",
"authorized_official_first_name": "ROSEMARY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "860-443-1891"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "003504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "003504",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.