Organization Active NPI

Naugatuck Valley Gastroenterology Consultants LLC

  • Gastroenterology Physician
  • Waterbury, CT
National Provider Identifier
1144350141
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NAUGATUCK VALLEY GASTROENTEROLOGY CONSULTANTS LLC
Practice address
1312 W Main St
Suite 101
Waterbury, CT 06708-3121
Phone
(203) 756-6422
Fax
(203) 756-2448
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Authorized official

Name
Mrs. Eileen S Paradis
Title
Administrator
Phone
(203) 756-6422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1312 W Main St
Suite 101
Waterbury, CT 06708-3121

Mailing address

1312 W Main St
Suite 101
Waterbury, CT 06708-3121
Phone (203) 756-6422

Other identifiers 2

IdentifierTypeStateIssuer
004146777MedicaidCT
CK2200OtherCTRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

166 Waterbury Rd
Ste 104
Prospect, CT 06712
Phone (203) 756-6422

Practitioners & affiliated clinicians

Practitioners 1

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1144350141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 W MAIN ST",
            "address_2": "SUITE 101",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083121",
            "telephone_number": "203-756-6422",
            "fax_number": "203-756-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W MAIN ST",
            "address_2": "SUITE 101",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083121",
            "telephone_number": "203-756-6422",
            "fax_number": "203-756-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUGATUCK VALLEY GASTROENTEROLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "PARADIS",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-756-6422",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004146777",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK2200",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.