Connecticut Urgent Care Centers, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CONNECTICUT URGENT CARE CENTERS, LLC

Doing business as

Connecticut Urgent Care Centers

Practice address

136 Berlin Rd
Cromwell, CT 06416-2627

Phone

(860) 378-8585

Fax

(860) 378-8586

NPI assigned

Mar 5, 2014

Last updated

May 26, 2015By 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

Linda K Gallacher

Title

Administrator

Phone

(860) 378-8585

Specialties & licenses 7

Addresses

Other identifiers 3

Other names 1

• Connecticut Urgent Care Centers Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anna Jeanne Ciccolini, PA-C

  • Medical Physician Assistant
  • Garner, NC
  • NPI 1104925254
  NPD (past)
• Darren A Ciccolini, PA-C

  • Medical Physician Assistant
  • Fuquay Varina, NC
  • NPI 1952328759
  NPD (past)

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1295151934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-378-8585",
            "fax_number": "860-378-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-378-8585",
            "fax_number": "860-378-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT URGENT CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "GALLACHER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-378-8585"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CT",
            "license": "0739",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "D100187528",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008056570",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "07D2075714",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Urgent Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Cromwell, CT
• Providers in Cromwell, CT by specialty
• General Practice Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.