Individual provider Active NPI

William James Rockwell, M.D.

  • Allergy Physician
  • Bridgeport, CT
National Provider Identifier
1285630798
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
017143 Issued in CT
Practice address
4675 Main St
Bridgeport, CT 06606-1813
Phone
(203) 374-6103
Fax
(203) 374-1663
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 017143 CT Primary

Addresses

Primary practice location

4675 Main St
Bridgeport, CT 06606-1813

Mailing address

4675 Main St
Bridgeport, CT 06606-1813
Phone (203) 374-6103

Other identifiers 4

IdentifierTypeStateIssuer
1171438MedicaidCT
0V0522OtherCTHEALTH NET
01-0017143CT01OtherCTANTHEM BLUE CROSS/BLUE SH
P381229OtherCTOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1285630798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061813",
            "telephone_number": "203-374-6103",
            "fax_number": "203-374-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061813",
            "telephone_number": "203-374-6103",
            "fax_number": "203-374-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CT",
            "license": "017143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1171438",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0V0522",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BLUE SH",
            "identifier": "01-0017143CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P381229",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.