Organization Active NPI

Pain & Spine Specialists of Connecticut LLC

  • Specialist
  • Trumbull, CT
National Provider Identifier
1457619660
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PAIN & SPINE SPECIALISTS OF CONNECTICUT LLC
Practice address
5520 Park Ave
303
Trumbull, CT 06611-3463
Phone
(203) 373-7330
Fax
(203) 373-7354
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Authorized official

Name
David C Levi, MD
Title
President
Phone
(203) 743-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

5520 Park Ave
303
Trumbull, CT 06611-3463

Mailing address

67 Sand Pit Rd
308
Danbury, CT 06810-4032
Phone (203) 743-7246

Other identifiers 1

IdentifierTypeStateIssuer
6472130003OtherCTPTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1457619660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 SAND PIT RD",
            "address_2": "308",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104032",
            "telephone_number": "203-743-7246",
            "fax_number": "203-792-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "address_2": "303",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-373-7330",
            "fax_number": "203-373-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN & SPINE SPECIALISTS OF CONNECTICUT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "LEVI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-743-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6472130003",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.