NPIMap

Organization Active NPI

Naval Branch Health Clinic New England

  • Health Service Clinic/Center
  • Groton, CT
National Provider Identifier
1265780936
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
R170002 Issued in MD
Legal business name
NAVAL BRANCH HEALTH CLINIC NEW ENGLAND
Practice address
1 Wahoo Ave
Groton, CT 06349-2324
Phone
(860) 694-4725
NPI assigned
Aug 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Mr. Mark Mammoth
Title
Medical Staff Professional Services
Phone
(860) 694-2377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X R170002 MD Primary

Addresses

Primary practice location

1 Wahoo Ave
Groton, CT 06349-2324

Mailing address

PO Box 600
Groton, CT 06349-5600
Phone (860) 694-4725

Other names 1

  • Naval Ambulatory Care Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Uss Pasadenassn75263 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1265780936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063492324",
            "telephone_number": "860-694-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAL BRANCH HEALTH CLINIC NEW ENGLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "MAMMOTH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEDICAL STAFF PROFESSIONAL SERVICES",
        "authorized_official_telephone_number": "860-694-2377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MD",
            "license": "R170002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Naval Ambulatory Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.