Individual provider Active NPI

John William Dorunda, M.D.

  • Family Medicine Physician
  • Groton, CT
National Provider Identifier
1215928973
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101222938 Issued in VA
Practice address
1 Wahoo Ave
NBHC Groton
Groton, CT 06340-2324
Phone
(860) 694-4123
Fax
(860) 694-1330
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101222938 VA Primary

Addresses

Primary practice location

1 Wahoo Ave
NBHC Groton
Groton, CT 06340-2324

Mailing address

1 Wahoo Avenue
NBHC Groton
Groton, CT 06349-5600
Phone (860) 694-4123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101222938VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1215928973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVENUE",
            "address_2": "NBHC GROTON",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-4123",
            "fax_number": "860-694-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "address_2": "NBHC GROTON",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402324",
            "telephone_number": "860-694-4123",
            "fax_number": "860-694-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORUNDA",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101222938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.