Ample Urgent and Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

AMPLE URGENT AND PRIMARY CARE LLC

Practice address

10 Princeton St
West Hartford, CT 06110-1893

Phone

(860) 707-5392

NPI assigned

Aug 25, 2022

Organization subpart

No

Name

Mojdeh Heidari, FNP-DNPNPI 1306300397

Title

Owner

Phone

(860) 707-5392

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mojdeh Heidari, FNP

  • Family Medicine Physician
  • West Hartford, CT
  • NPI 1306300397

  CT

  Medicare reassignment NPD Authorized official
• Elizabeth Romac Karrenberg, D.P.M.

  • Podiatrist
  • West Hartford, CT
  • NPI 1477585297
  NPD

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2022.

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1497474191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PRINCETON ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101893",
            "telephone_number": "860-707-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PRINCETON ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101893",
            "telephone_number": "860-707-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLE URGENT AND PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "HEIDARI",
        "authorized_official_first_name": "MOJDEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-707-5392",
        "authorized_official_credential": "FNP-DNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Susan A Anderson, COTA

• All providers in West Hartford, CT
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.