NPIMap

Organization Active NPI

State of Connecticut

  • Psychiatric Hospital
  • Middletown, CT
National Provider Identifier
1366950206
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF CONNECTICUT
Practice address
70 O'Brien Drive
Middletown, CT 06457
Phone
(860) 418-6918
NPI assigned
Jan 12, 2018
Organization subpart
Yes
Parent organization
STATE OF CONNECTICUTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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

Authorized official

Name
Mr. Stephen Dipietro
Title
Chief Fiscal Officer
Phone
(860) 418-6926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

70 O'Brien Drive
Middletown, CT 06457

Mailing address

PO Box 70
Middletown, CT 06457-0070

Other names 1

  • Whiting Forensic Hospital Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2147513Whiting Forensic Hospital70 O'Brien Dr, Middletown, CT 06457Certificate of waiverApr 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
John Dempsey Hosp74 organizations share this tax ID, including this one
Part of
John Dempsey Hosp

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1366950206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064570070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 O'BRIEN DRIVE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-418-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF CONNECTICUT",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "DIPIETRO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FISCAL OFFICER",
        "authorized_official_telephone_number": "860-418-6926",
        "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": "Whiting Forensic Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.