Active NPI
Katheryn E Grossman, PA-C
- Physician Assistant
- New London, CT
National Provider Identifier
1124370275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002827
- Practice address
- 365 Montauk Ave
New London, CT 06320-4700 - Phone
- (860) 444-5104
- NPI assigned
- Oct 12, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002827 | CT | Primary |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4700
Mailing address
11 Cape Ann CT
New London, CT 06320-3701
Phone (860) 912-0762
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002827 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New England Urgent Care Enfield LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba New England Urgent Care Enfield
- Urgent Care Clinic/Center
- Enfield, CT
- NPI 1184995144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1124370275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CAPE ANN CT",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063203701",
"telephone_number": "860-912-0762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204700",
"telephone_number": "860-444-5104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "KATHERYN",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-12",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "002827",
"primary": true
}
],
"identifiers": [],
"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 Oct 12, 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.