Organization Active NPI

Ancillary-X LLC

  • Durable Medical Equipment & Medical Supplies
  • Shelton, CT
National Provider Identifier
1174357974
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ANCILLARY-X LLC
Practice address
1 Parrott Drive
Ste 400
Shelton, CT 06484
Phone
(203) 435-4089
NPI assigned
Aug 26, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Ivan Nussberg
Title
Managing Partner/Coo
Phone
(203) 435-4089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1 Parrott Drive
Ste 400
Shelton, CT 06484

Mailing address

1 Parrott Drive
Ste 400
Shelton, CT 06484

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1174357974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARROTT DRIVE",
            "address_2": "STE 400",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "06484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARROTT DRIVE",
            "address_2": "STE 400",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "06484",
            "telephone_number": "203-435-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCILLARY-X LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "NUSSBERG",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "MANAGING PARTNER/COO",
        "authorized_official_telephone_number": "203-435-4089"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.