NPIMap

Organization Active NPI

Norwich Pediatric Group, P.C.

  • Pediatrics Physician
  • Norwich, CT
National Provider Identifier
1134329485
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORWICH PEDIATRIC GROUP, P.C.
Practice address
92 New London Tpke
Norwich, CT 06360-2637
Phone
(860) 889-3401
Fax
(860) 823-1782
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Mrs. Anita M Maxim
Title
Office Manager
Phone
(860) 889-3401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

92 New London Tpke
Norwich, CT 06360-2637

Mailing address

92 New London Tpke
Norwich, CT 06360-2637
Phone (860) 889-3401

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0095701Norwich Pediatric Group PC92 New London Tpke, Norwich, CT 06360Certificate of waiverNov 3, 2026

National Provider Directory

National Provider Directory

Locations

212 Upton Rd
Colchester, CT 06415
Phone (860) 822-4719

92 New London Tpke
Norwich, CT 06360
Phone (860) 889-3401

92 New London Tpke
Ste 1
Norwich, CT 06360

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1134329485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602637",
            "telephone_number": "860-889-3401",
            "fax_number": "860-823-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602637",
            "telephone_number": "860-889-3401",
            "fax_number": "860-823-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWICH PEDIATRIC GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "MAXIM",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-889-3401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.