Individual provider Active NPI

Brenda Louise Applegate, M.D.

  • Family Medicine Physician
  • Pawcatuck, CT
National Provider Identifier
1255437752
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
035827 Issued in CT
Practice address
91 Voluntown Rd
Pawcatuck, CT 06379-1366
Phone
(860) 599-5477
Fax
(860) 599-5676
NPI assigned
Sep 15, 2006
Last updated
Jan 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2013

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 035827 CT Primary

Addresses

Primary practice location

91 Voluntown Rd
Pawcatuck, CT 06379-1366

Mailing address

91 Voluntown Rd
Pawcatuck, CT 06379-1366
Phone (860) 599-5477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714003790 CO Practitioner - Family Practice 0648356782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care ColoradoGroup PAC ID 7214295989, 23 clinicians

Practice addresses (Care Compare)

110 E Boardwalk
Fort Collins, CO 80525-3047
Phone (970) 821-1500

2555 E 13TH St
Suite 110
Loveland, CO 80537-5134
Phone (970) 820-4264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
035827CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Colorado CurrentSince Sep 1, 2021 Accepting new patients
Banner Urgent Care Colorado CurrentSince Sep 1, 2021 Accepting new patients

Locations

2001 70th Ave
Ste 110
Greeley, CO 80634
Phone (970) 378-4155

2555 E 13th St
Ste 110
Loveland, CO 80537
Phone (970) 461-6140

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1255437752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 VOLUNTOWN RD",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791366",
            "telephone_number": "860-599-5477",
            "fax_number": "860-599-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 VOLUNTOWN RD",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791366",
            "telephone_number": "860-599-5477",
            "fax_number": "860-599-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLEGATE",
        "first_name": "BRENDA",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "035827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawcatuck, CT

Sources for this page

Verify at the official NPI Registry.