Crescent Street Obstetrics & Gynecology LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

025189 Issued in CT

Legal business name

CRESCENT STREET OBSTETRICS & GYNECOLOGY LLC

Practice address

49 Crescent Street
Middletown, CT 06457-3601

Phone

(860) 344-9993

Fax

(860) 344-9844

NPI assigned

Jan 4, 2011

Last updated

Jan 5, 2011By 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

Dr. Julie S Flagg, M.D.NPI 1760435879

Title

Owner

Phone

(860) 344-9993

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Crescent St OBGYN LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Crescent St OBGYN LLC

  • Nurse Practitioner
  • Middletown, CT
  • NPI 1184884355
  NPD tax ID

Practitioners 1

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.

• Julie S Flagg III

  • Obstetrics & Gynecology Physician
  • Middletown, CT
  • NPI 1760435879
  Authorized official Same address or phone

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1255635371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CRESCENT STREET",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573601",
            "telephone_number": "860-344-9993",
            "fax_number": "860-344-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CRESCENT STREET",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573601",
            "telephone_number": "860-344-9993",
            "fax_number": "860-344-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT STREET OBSTETRICS & GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "FLAGG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-344-9993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "025189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004089729",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Crain, MD
• Lindsay R Crebase, LCSW
• Patrick J Creedon, PA-C
• Crescent Counseling and Wellness LLC (Crescent Counseling and Wellness)
• Crescent St OBGYN LLC
• Crescent Street Obstetrics and Gynecology LLC
• Mary Ann Crewdson, LCSW, CPT, QMHP
• Laina Jean Cross, MSN
• Betsy Ann Crosswell, DMD
• Carly Croteau, PT, DPT

• Obstetrics & Gynecology Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Obstetrics & Gynecology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.