Organization Active NPI

Pediatric House Call Solutions LLC

  • Pediatric Nurse Practitioner
  • Milford, CT
National Provider Identifier
1174928790
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
002351 Issued in CT
Legal business name
PEDIATRIC HOUSE CALL SOLUTIONS LLC
Practice address
167 Cherry St
Suite 112
Milford, CT 06460-7639
Phone
(203) 893-5394
Fax
(855) 766-3951
NPI assigned
Oct 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Mr. Charles F Wetmore, APRN
Title
Owner
Phone
(203) 893-5394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 002351 CT Primary

Addresses

Primary practice location

167 Cherry St
Suite 112
Milford, CT 06460-7639

Mailing address

62 Platt St
Milford, CT 06460-7639
Phone (203) 893-5394

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
07D2081397Pediatric House Call Solutions167 Cherry St, Milford, CT 06460Certificate of waiverJul 23, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1174928790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 PLATT ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064607639",
            "telephone_number": "203-893-5394",
            "fax_number": "855-766-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 CHERRY ST",
            "address_2": "SUITE 112",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064607639",
            "telephone_number": "203-893-5394",
            "fax_number": "855-766-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HOUSE CALL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "WETMORE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-893-5394",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.