Edward McDermott MD

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

B84483 Issued in CT

Legal business name

EDWARD MCDERMOTT MD

Practice address

276 Montauk Ave # R
New London, CT 06320-4727

Phone

(860) 442-0930

Fax

(860) 447-8598

NPI assigned

Mar 14, 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

Edward McDermott, MDNPI 1356324008

Title

Owner

Phone

(860) 442-0930

Specialties & licenses 1

Addresses

Tax ID family

Edward McDermott MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Edward McDermott, MD

  • Internal Medicine Physician
  • New London, CT
  • NPI 1629109467
  NPD tax ID

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.

• Edward J McDermott, M.D.

  • Internal Medicine Physician
  • Groton, CT
  • NPI 1356324008
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518090976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 MONTAUK AVE # R",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204727",
            "telephone_number": "860-442-0930",
            "fax_number": "860-447-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 MONTAUK AVE # R",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204727",
            "telephone_number": "860-442-0930",
            "fax_number": "860-447-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD MCDERMOTT MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-442-0930",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "B84483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joann M Eaccarino, APRN
• East Lyme Caregivers Caregivers
• Eastern Connecticut Surgical Care
• Eastern Shore Chiropractic Center, L.L.C.
• Gretchen Edstrom, RN, CDE
• Edward McDermott, MD
• Owen Ehrlich, M.D.
• Julia Eisenstein
• Asim Ejaz, M.D.
• Alexander James Ejzak, P.A.

• Nurse Practitioner in New London, CT
• Providers in New London, CT by specialty
• Nurse Practitioner 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.