NPIMap

Organization Active NPI

Primary Care of Mystic PC

  • Internal Medicine Physician
  • Mystic, CT
National Provider Identifier
1356571814
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
047587 Issued in CT
Legal business name
PRIMARY CARE OF MYSTIC PC
Practice address
41 E Main St
Mystic, CT 06355-2831
Phone
(860) 572-2988
NPI assigned
Jul 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Authorized official

Name
Dr. Louis C Iovino, D.O.NPI 1396825097
Title
Owner / Physician
Phone
(757) 753-0010

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 046497 CT
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 047587 CT Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X DO00649 RI
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 046497 CT

Addresses

Primary practice location

41 E Main St
Mystic, CT 06355-2831

Mailing address

41 E Main St
Mystic, CT 06355-2831
Phone (860) 572-2988

National Provider Directory

National Provider Directory

Locations

41 E Main St
Mystic, CT 06355
Phone (860) 536-2995

Practitioners & affiliated clinicians

Practitioners 2

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": "1247875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1356571814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E MAIN ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552831",
            "telephone_number": "860-572-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E MAIN ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552831",
            "telephone_number": "860-572-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF MYSTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-18",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "IOVINO",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "757-753-0010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "046497",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "047587",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "DO00649",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "046497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.