Austin Chinedu Tagbo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

040105 Issued in CT

Practice address

112 Mansfield Ave
Willimantic, CT 06226-2041

Phone

(860) 680-6119

NPI assigned

Mar 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midcoast Hospital

  • Internal Medicine Physician
  • Bath, ME
  • NPI 1083636039
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306979851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PARKWOODS DR",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607524",
            "telephone_number": "860-680-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-680-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGBO",
        "first_name": "AUSTIN",
        "middle_name": "CHINEDU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalagena M Sullivan
• Surgical Associates of Windham PC
• Craig D Sweeney, MD
• Swift Running Waters Counseling
• Ryan Tacy
• Meghan Eve Tarvis, RN
• Nicole Monique Taylor, MD
• Shellina Taylor, APRN
• Victorio Go Te, MD
• The Foot Group, LLC

• Internal Medicine Physician in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.