Connecticut Imaging Partners, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CONNECTICUT IMAGING PARTNERS, LLC

Practice address

100 Hazard Ave
Enfield, CT 06082-5446

Phone

(860) 283-3375

Fax

(860) 783-5733

NPI assigned

Jul 16, 2010

Last updated

Dec 21, 2010By 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

Shawnee Moody

Title

Credentialing Coordinator

Phone

(860) 289-3375

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1275846453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "SUITE 400 - CREDENTIALING",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-289-3375",
            "fax_number": "860-783-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825446",
            "telephone_number": "860-283-3375",
            "fax_number": "860-783-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT IMAGING PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "SHAWNEE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "860-289-3375"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004252110",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis S Competiello, MD
• Connecticut CVS Pharmacy LLC (CVS Pharmacy #16603)
• Connecticut CVS Pharmacy LLC. (CVS Pharmacy # 01098)
• Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy # 00750)
• Connecticut Eye Care, LLC
• Connecticut Medical Supply LLC
• Connecticut Surgical Group, PC
• Connecticut Valley General & Vascular Surgical Assoc PC
• Gregg A Connolly
• Joni Ann Conroy, LPC

• Diagnostic Radiology Physician in Enfield, CT
• Providers in Enfield, CT by specialty
• Diagnostic Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.