Urgent Care of Berlin, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

URGENT CARE OF BERLIN, LLC

Doing business as

PhysicianOne Urgent Care

Practice address

175 Webster Square Rd
Berlin, CT 06037-2328

Phone

(860) 420-3660

NPI assigned

Jul 24, 2019

Last updated

Jul 24, 2019By 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

Jeannie M Kenkare, DO

Title

Cmo

Phone

(203) 616-4440

Specialties & licenses 1

Addresses

Other names 1

• PhysicianOne Urgent Care Doing business as

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1336792720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 MAIN ST STE 101",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331007",
            "telephone_number": "860-430-1246",
            "fax_number": "203-905-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WEBSTER SQUARE RD",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372328",
            "telephone_number": "860-420-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE OF BERLIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "KENKARE",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "203-616-4440",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PhysicianOne Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urgent Care Clinic/Center in Berlin, CT
• Providers in Berlin, CT by specialty
• Urgent Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.