Beaver Pond Brook Emergency Physicians LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

BEAVER POND BROOK EMERGENCY PHYSICIANS LLC

Practice address

3081 E Main St
Waterbury, CT 06705-3424

Phone

(469) 401-2386

NPI assigned

Jun 5, 2017

Organization subpart

No

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

Authorized official

Name

Russell Harris, MD

Title

Officer

Phone

(469) 401-2386

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496620800000",
    "number": "1386173201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401374",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3081 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053424",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER POND BROOK EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-401-2386",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sabra Becker, PA
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• Nadine Behmke

• All providers in Waterbury, CT
• Emergency Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.