NPIMap

Organization Active NPI

Naugatuck Valley Weight Loss Center LLC

Doing business as Medi-Weightloss

  • Family Medicine Physician
  • Orange, CT
National Provider Identifier
1386040186
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NAUGATUCK VALLEY WEIGHT LOSS CENTER LLC
Doing business as
Medi-Weightloss
Practice address
109 Boston Post Rd
Orange, CT 06477-3235
Phone
(203) 891-0655
Fax
(866) 581-0408
NPI assigned
Nov 6, 2014
Last updated
Jun 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Jodi Despoy
Title
Manager
Phone
(813) 228-6334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

109 Boston Post Rd
Orange, CT 06477-3235

Mailing address

509 S Hyde Park Ave
Tampa, FL 33606-2266
Phone (813) 228-6334

Other names 1

  • Medi-Weightloss 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
07D2044223Naugatuck Valley Weight Loss Center LLC109 Boston Post Rd, Orange, CT 06477Certificate of waiverJul 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Medi-Weightloss2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1386040186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S HYDE PARK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062266",
            "telephone_number": "813-228-6334",
            "fax_number": "813-228-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773235",
            "telephone_number": "203-891-0655",
            "fax_number": "866-581-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUGATUCK VALLEY WEIGHT LOSS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "DESPOY",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-228-6334"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi-Weightloss",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medi-Weightloss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.