Connecticut Surgical Group, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CONNECTICUT SURGICAL GROUP, PC

Practice address

1260 Silas Deane Hwy
Wethersfield, CT 06109-4362

Phone

(860) 547-0614

Fax

(860) 524-2655

NPI assigned

Nov 28, 2005

Last updated

Aug 11, 2010By 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

Douglas C McKell

Title

Chief Administrative Officer

Phone

(860) 524-4326

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1225011927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 TALCOTT NOTCH RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321818",
            "telephone_number": "860-947-0616",
            "fax_number": "860-524-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094362",
            "telephone_number": "860-547-0614",
            "fax_number": "860-524-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT SURGICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "MCKELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "860-524-4326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004139350",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "50CONNSURCT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connecticut Anesthesia and Pain Associates PLLC (B.D. Interventional Pain Management Center)
• Connecticut CVS Pharmacy LLC (CVS Pharmacy #00348)
• Connecticut Ear, Nose & Throat Associates, P.C.
• Connecticut Hearing Center
• Connecticut Imaging Partners, LLC
• John J Conroy, D.M.D, M.S.
• Allan Costa Jr., PHARM.D.
• Counseling for Change and Growth LLC
• Lillian Couture, LPC
• Theresa Creamer, PA-C, RD

• Durable Medical Equipment & Medical Supplies in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.