Active NPI
Uconn Health Community Network Medical Group, Inc.
- Family Medicine Physician
- Waterbury, CT
National Provider Identifier
1548119522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- UCONN HEALTH COMMUNITY NETWORK MEDICAL GROUP, INC.
- Practice address
- 64 Robbins St
Waterbury, CT 06708-2613 - Phone
- (203) 573-7280
- NPI assigned
- Jan 23, 2026
- 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
- Jeffrey Geoghegan
- Title
- Executive Director
- Phone
- (860) 679-3162
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Registered Nurse | 163W00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Gynecologic Oncology Physician | 207VX0201X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Surgery Physician | 208600000X | |||
| Vascular Surgery Physician | 2086S0129X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | |||
| Hospitalist Physician | 208M00000X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
64 Robbins St
Waterbury, CT 06708-2613
Mailing address
1625 Straits Turnpike
Suite 211
Middlebury, CT 06762-1836
Phone (203) 573-9512
National Provider Directory
National Provider DirectoryLocations
10 N Benson Rd
Middlebury, CT 06762
Phone (203) 758-1316
1320 W Main St
Waterbury, CT 06708
Phone (203) 709-7300
300 Wolcott Rd
Wolcott, CT 06716
Phone (203) 879-8003
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Wolcott, CT
- NPI 1316085665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788307200000",
"number": "1548119522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 STRAITS TURNPIKE",
"address_2": "SUITE 211",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067621836",
"telephone_number": "203-573-9512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 ROBBINS ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067082613",
"telephone_number": "203-573-7280"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UCONN HEALTH COMMUNITY NETWORK MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-01-23",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A",
"authorized_official_last_name": "GEOGHEGAN",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "860-679-3162"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VX0201X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.