NPIMap

Organization Active NPI

Hummingbird Trauma Resolution, LLC

  • Primary Care Nurse Practitioner
  • Branford, CT
National Provider Identifier
1508313933
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
000440 Issued in CT
Legal business name
HUMMINGBIRD TRAUMA RESOLUTION, LLC
Practice address
130 Montowese St Ste 5
Branford, CT 06405-3841
Phone
(203) 440-9288
Fax
(203) 440-9288
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Beth Robins Roth, APRN, SEPNPI 1316044845
Title
Owner/Member
Phone
(203) 824-1249

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 Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 000440 CT Primary

Addresses

Primary practice location

130 Montowese St Ste 5
Branford, CT 06405-3841

Mailing address

PO Box 185301
Hamden, CT 06518-0301
Phone (203) 824-1249

Other names 1

  • HUMMINGBIRD TRAUMA RESOLUTION, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206000470 CT Part B Supplier - Clinic/Group Practice 6901189596 Receives reassigned benefits from 1 practitioner
Practice locations: Branford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1508313933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185301",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065180301",
            "telephone_number": "203-824-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MONTOWESE ST STE 5",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053841",
            "telephone_number": "203-440-9288",
            "fax_number": "203-440-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMMINGBIRD TRAUMA RESOLUTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ROBINS",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "203-824-1249",
        "authorized_official_credential": "APRN,  SEP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "000440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUMMINGBIRD TRAUMA RESOLUTION, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.