Day Kimball Healthcare, Inc.
Organization Active NPI Community Health Clinic/Center · Putnam, CT
NPI 1265540967 · NPPES record last updated Nov 17, 2017
Key facts
- NPI
- 1265540967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- License
- 0043 (CT)
- Legal business name
- DAY KIMBALL HEALTHCARE, INC.
- Practice address
- 320 Pomfret St
Putnam, CT 06260-1836 - Phone
- (860) 928-6541
- Fax
- (860) 928-5341
- NPI assigned
- Aug 25, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- DAY KIMBALL HEALTHCARE, INC.
Authorized official
- Name
- Mrs. Annemarie H Diamond
- Title
- President/Ceo
- Phone
- (860) 928-6541
Other NPIs on the same Medicare enrollment 4
Practitioners 29
-
Anca Bulgaru, MD
-
Lisa T Canter, MD,FACC
-
Marc B Cerrone, MD
-
Anthony Chieffalo, M.D.
-
Mandeep Dhami, MD
-
Gail Louise Dickinson, M.D.
-
Erica Kesselman, MD
-
Ronald W. Klare, MD
-
Sherry Lee Kroll, MD
-
Lacey Bryn Luneau, PA-C
-
Andrew Paul Mackenzie, M.D.
-
Kathleen Mackenzie, APRN
-
Krista E Matsen, MD
-
John Modica, MD
-
Robert Moes, MD
-
Lisa A. Muray, M.S., L.P.C
-
Elena Poloukhine, MD
-
Lisa M Reardon, LCSW
-
Dennis Slater, MD
-
Michelle Renee Taylor, M.D.
-
Richard Jay Wilcon, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041229001007 | CT | Part B Supplier - Clinic/Group Practice | 5092773549 |
Receives reassigned benefits from 57 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Danielson, CT; Plainfield, CT; Putnam, CT |
National Provider Directory
- Part of
- Day Kimball Healthcare Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | 0043 | CT | |
| Midwife |
176B00000X | |||
| Family Medicine Physician |
207Q00000X | 0043 | CT | |
| Internal Medicine Physician |
207R00000X | 0043 | CT | |
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | 0043 | CT | |
| Hematology & Oncology Physician |
207RH0003X | 0043 | CT | |
| Pulmonary Disease Physician |
207RP1001X | 0043 | CT | |
| Obstetrics & Gynecology Physician |
207V00000X | 0043 | CT | |
| Reproductive Endocrinology Physician |
207VE0102X | 0043 | CT | |
| Pediatrics Physician |
208000000X | 0043 | CT | |
| Community Health Clinic/Center | 261QC1500X | 0043 | CT | Yes |
| Nurse Practitioner |
363L00000X | |||
| Gerontology Nurse Practitioner |
363LG0600X | |||
| Pediatric Nurse Practitioner |
363LP0200X |
Addresses
Primary practice location
320 Pomfret St
Putnam, CT 06260-1836
Mailing address
320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004024931 | Medicaid | CT |
Other providers in Putnam, CT
- David L. Yeager, MD PC
- Brittany Davis
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Healthcare, Inc.
- Day Kimball Hospital Diabetes Education Program
All providers in Putnam, CT · Community Health Clinic/Center in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.