Individual provider Active NPI

Emily Pamela Stanford, DO

  • Internal Medicine Physician
  • Wethersfield, CT
National Provider Identifier
1114190964
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
049933 Issued in CT
Practice address
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone
(860) 679-2000
NPI assigned
Apr 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 049933 CT
Internal Medicine Physician 207R00000X 049933 CT Primary

Addresses

Primary practice location

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337

Mailing address

112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-9116

Other names 1

  • Emily Pamela Reynolds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000145 CT Practitioner - Internal MedicinePractitioner - Addiction Medicine 4587836507 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Rowan University School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Windham Community Memorial Hospital IncGroup PAC ID 2961309059, 67 clinicians
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-9116

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024
  • Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
049933CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The William W Backus Hospital Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 7, 2017 Accepting new patients
The William W Backus Hospital Internal Medicine CurrentSince Oct 15, 2021 Accepting new patients
Windham Community Memorial Hospital, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Rushford Center, Inc. CurrentSince May 1, 2025 Accepting new patients
William W Backus Hospital CurrentSince Oct 15, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 7, 2017 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

883 Paddock Ave
Meriden, CT 06450
Phone (203) 630-5220

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: emily.stanford@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1114190964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-456-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-679-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "EMILY",
        "middle_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CT",
            "license": "049933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "049933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "REYNOLDS",
            "middle_name": "PAMELA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.