NPIMap

Organization Active NPI

Pediatric Care Associates of Connecticut

  • Pediatric Adolescent Medicine Physician
  • Shelton, CT
National Provider Identifier
1396867958
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
PEDIATRIC CARE ASSOCIATES OF CONNECTICUT
Practice address
25 Constitution Blvd. So
Pedi-Care
Shelton, CT 06484-1300
Phone
(203) 924-7334
Fax
(203) 922-0004
NPI assigned
Apr 4, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Marie Leclerc
Title
Office Manager
Phone
(203) 924-7334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X CT Primary

Addresses

Primary practice location

25 Constitution Blvd. So
Pedi-Care
Shelton, CT 06484-1300

Mailing address

25 Constitution Blvd S
Pedi-Care
Shelton, CT 06484-4351
Phone (203) 924-7334

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396867958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CONSTITUTION BLVD S",
            "address_2": "PEDI-CARE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844351",
            "telephone_number": "203-924-7334",
            "fax_number": "203-922-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CONSTITUTION BLVD. SO",
            "address_2": "PEDI-CARE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064841300",
            "telephone_number": "203-924-7334",
            "fax_number": "203-922-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE ASSOCIATES OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LECLERC",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-924-7334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.