Active NPI
Life Choice Hospice of Connecticut LLC
- Hospice and Palliative Medicine (Family Medicine) Physician
- Milford, CT
National Provider Identifier
1457949208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician
- Legal business name
- LIFE CHOICE HOSPICE OF CONNECTICUT LLC
- Practice address
- 612 Wheelers Farms Rd Ste 103
Milford, CT 06461-1673 - Phone
- (203) 301-0489
- Fax
- (203) 301-0632
- NPI assigned
- Jan 7, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Russell Adkins
- Title
- SVP Chief Legal Officer
- Phone
- (615) 309-5668
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | Primary | ||
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
612 Wheelers Farms Rd Ste 103
Milford, CT 06461-1673
Mailing address
10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022
Other practice location 1
100 Corporate Pl Ste 205
Rocky Hill, CT 06067-1803
Phone (860) 856-5994
Other names 1
- Compassus - Greater Connecticut
National Provider Directory
National Provider DirectoryLocations
612 Wheelers Farms Rd
Ste 103
Milford, CT 06461
Phone (203) 301-0489
472 Wheelers Farms Rd
Ste 302
Milford, CT 06461
Phone (203) 301-0489
109 Boston Post Rd
#202203
Orange, CT 06477
Phone (203) 301-0489
100 Corporate Pl
Ste 205
Rocky Hill, CT 06067
Phone (860) 856-5994
10 Cadillac Dr
Ste 110
Brentwood, TN 37027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609977600000",
"number": "1457949208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CADILLAC DR STE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370271001",
"telephone_number": "615-377-7022",
"fax_number": "615-373-4457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 WHEELERS FARMS RD STE 103",
"city": "MILFORD",
"state": "CT",
"postal_code": "064611673",
"telephone_number": "203-301-0489",
"fax_number": "203-301-0632"
}
],
"practiceLocations": [
{
"address_1": "100 Corporate Pl Ste 205",
"address_purpose": "LOCATION",
"city": "Rocky Hill",
"state": "CT",
"postal_code": "060671803",
"country_code": "US",
"telephone_number": "860-856-5994",
"fax_number": "866-955-8536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LIFE CHOICE HOSPICE OF CONNECTICUT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-07",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A",
"authorized_official_last_name": "ADKINS",
"authorized_official_first_name": "RUSSELL",
"authorized_official_title_or_position": "SVP CHIEF LEGAL OFFICER",
"authorized_official_telephone_number": "615-309-5668"
},
"taxonomies": [
{
"code": "207QH0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Hospice and Palliative Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RH0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Compassus - Greater Connecticut",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.