Coventry Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

026639 Issued in CT

Legal business name

COVENTRY INTERNAL MEDICINE

Practice address

1366 Main St
Coventry, CT 06238-3168

Phone

(860) 742-0807

Fax

(860) 742-8702

NPI assigned

Sep 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael E. Keenan, M.D.

Title

President

Phone

(860) 742-0807

Specialties & licenses 1

Addresses

Other names 1

• Michael E. Keenan, M.D. Other name

Locations

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1346435898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 MAIN ST",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062383168",
            "telephone_number": "860-742-0807",
            "fax_number": "860-742-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 MAIN ST",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062383168",
            "telephone_number": "860-742-0807",
            "fax_number": "860-742-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENTRY INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-742-0807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "026639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael E. Keenan, M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chastity J. Pimental LCSW, PLLC
• Chattersoupe, PLLC
• Serena Chestnut
• Kevin Cobb
• Connecticut CVS Pharmacy, L.L.C.
• Coventry Oral and Implant Surgery PLLC
• Coventry Public Schools
• Cpa LLC
• Kasey Cushman, FNP-BC
• Alisa Lyudmila Da Costa-Rodrigues, APRN

• All providers in Coventry, CT
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.