State of Connecticut

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

STATE OF CONNECTICUT

Practice address

525 Russell Rd
Newington, CT 06111

Phone

(860) 666-7681

Fax

(860) 666-7675

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Albert Crompton

Title

Chief Financial Officer

Phone

(860) 418-6923

Specialties & licenses 1

Addresses

Other names 1

• DBA Cedarcrest Hospital Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Hospital certification: CCN 074009

Legal name

CEDARCREST REGIONAL HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Jul 1, 2010

Provider type (POS)

Hospital – Psychiatric

Participating since

Jun 16, 1981

Last certification

Feb 4, 2010

Beds

139

Ownership / control type

State

Facility address

525 Russell Road
Newington, CT 06111

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• State of Connecticut

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434

  O20041227000221

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Briana Senae Graham

  • Clinical Social Worker
  • Bridgeport, CT
  • NPI 1518541937
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366477903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 RUSSELL RD",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-7681",
            "fax_number": "860-666-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 RUSSELL RD",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-7681",
            "fax_number": "860-666-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROMPTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-418-6923",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Cedarcrest Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Srokowski, DPT, OCS, FAAOMPT
• Robert Stair, PT
• Starling Physicians PC
• Starting Point, LLC
• Craig Allen Stasulis, D.M.D., M.D.
• State of CT. - Office of the Comptroller
• State of CT. - Office of the Comptroller
• State of CT. - Office of the Comptroller
• State of CT. - Office of the Comptroller
• State of CT. - Office of the Comptroller

• Psychiatric Hospital in Newington, CT
• Providers in Newington, CT by specialty
• Psychiatric Hospital in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.