Athena Osteopathy, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

55916 Issued in CT

Legal business name

ATHENA OSTEOPATHY, LLC

Practice address

315 E Center St
Manchester, CT 06040-5251

Phone

(860) 533-0179

Fax

(866) 603-4163

NPI assigned

Jul 11, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aj Eckert, DO

Title

Owner

Phone

(860) 533-0179

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174045223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405251",
            "telephone_number": "860-533-0179",
            "fax_number": "866-603-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405251",
            "telephone_number": "860-533-0179",
            "fax_number": "866-603-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA OSTEOPATHY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ECKERT",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-533-0179",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "55916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Manchester, CT
• Providers in Manchester, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.