NPIMap

Organization Active NPI

Anchor Health Initiative Corp.

  • Primary Care Clinic/Center
  • Stamford, CT
National Provider Identifier
1245773191
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ANCHOR HEALTH INITIATIVE CORP.
Practice address
30 Myano LN Ste 16
Stamford, CT 06902-4532
Phone
(203) 674-1102
NPI assigned
Nov 27, 2016
Last updated
Apr 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

Name
Patricia Walsh Chadwick
Title
Ceo
Phone
(203) 698-0676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

30 Myano LN Ste 16
Stamford, CT 06902-4532

Mailing address

30 Myano LN Ste 16
Stamford, CT 06902-4532

Other practice location 1

30 Myano Ln
Stamford, CT 06902-4532
Phone (203) 674-1102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180206000691 CT Part B Supplier - Clinic/Group Practice 1759641038 Receives reassigned benefits from 11 practitioners
Practice locations: Hamden, CT; New Haven, CT; Stamford, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Anchor Health Initiative Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2200 Whitney Ave
Ste 290
Hamden, CT 06518
Phone (203) 407-8080

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1245773191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MYANO LN STE 16",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MYANO LN STE 16",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024532",
            "telephone_number": "203-674-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Myano Ln",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069024532",
            "country_code": "US",
            "telephone_number": "203-674-1102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANCHOR HEALTH INITIATIVE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-27",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "WALSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-698-0676"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.