NPIMap

Organization Active NPI

Mansfield Pediatrics LLC

  • Pediatrics Physician
  • Mansfield Center, CT
National Provider Identifier
1285729780
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MANSFIELD PEDIATRICS LLC
Practice address
12A Ledgebrook Drive
Mansfield Center, CT 06250
Phone
(860) 423-2960
Fax
(860) 423-3719
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Craig R Elliott, M.D.NPI 1275581472
Title
Medical Doctor
Phone
(860) 423-2960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

12A Ledgebrook Drive
Mansfield Center, CT 06250

Mailing address

12A Ledgebrook Drive
Mansfield Center, CT 06250
Phone (860) 423-2960

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285729780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12A LEDGEBROOK DRIVE",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "06250",
            "telephone_number": "860-423-2960",
            "fax_number": "860-423-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12A LEDGEBROOK DRIVE",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "06250",
            "telephone_number": "860-423-2960",
            "fax_number": "860-423-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "860-423-2960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield Center, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.