J. Andrew Hallberg, MD, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

029044 Issued in CT

Legal business name

J. ANDREW HALLBERG, MD, LLC

Practice address

56 Whitehall Ave
Suite a
Mystic, CT 06355-1967

Phone

(860) 536-0773

Fax

(860) 536-1068

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John A Hallberg, M.D.NPI 1912971508

Title

Owner

Phone

(860) 536-0773

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• John Andrew Hallberg, MD

  • Orthopaedic Surgery Physician
  • Fort Kent, ME
  • NPI 1912971508
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487770228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WHITEHALL AVE",
            "address_2": "SUITE A",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551967",
            "telephone_number": "860-536-0773",
            "fax_number": "860-536-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WHITEHALL AVE",
            "address_2": "SUITE A",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551967",
            "telephone_number": "860-536-0773",
            "fax_number": "860-536-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. ANDREW HALLBERG, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALLBERG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-536-0773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "029044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandi Lynn Iovino, D.O.
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• Giulia Jaramillo, MS LMFT
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• Specialist in Mystic, CT
• Providers in Mystic, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.