Organization Active NPI

Connecticut Primary Care and Wellness PC

  • Primary Care Clinic/Center
  • Middlebury, CT
National Provider Identifier
1407378946
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONNECTICUT PRIMARY CARE AND WELLNESS PC
Practice address
530 Middlebury Rd Ste 103a
Middlebury, CT 06762-2547
Phone
(203) 527-6953
Fax
(203) 528-4331
NPI assigned
Jul 15, 2017
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Ines Zemaitis, APRNNPI 1821263328
Title
NP/Ceo
Phone
(203) 768-6770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

530 Middlebury Rd Ste 103a
Middlebury, CT 06762-2547

Mailing address

530 Middlebury Rd Ste 103a
Middlebury, CT 06762-2547
Phone (203) 527-6953

Other identifiers 1

IdentifierTypeStateIssuer
008075293MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170914002857 CT Part B Supplier - Clinic/Group Practice 3779857727 Receives reassigned benefits from 3 practitioners
Practice locations: Middlebury, CT

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
07D2134251Connecticut Primary Care and Wellness, PC530 Middlebury Rd, Ste 103a, Middlebury, CT 06762Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

Locations

530 Middlebury Rd
Ste 103A
Middlebury, CT 06762
Phone (203) 527-6953

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16511/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1500076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1407378946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 MIDDLEBURY RD STE 103A",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622547",
            "telephone_number": "203-527-6953",
            "fax_number": "203-528-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MIDDLEBURY RD STE 103A",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622547",
            "telephone_number": "203-527-6953",
            "fax_number": "203-528-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT PRIMARY CARE AND WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-15",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "ZEMAITIS",
        "authorized_official_first_name": "INES",
        "authorized_official_title_or_position": "NP/CEO",
        "authorized_official_telephone_number": "203-768-6770",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008075293",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.