NPIMap

Organization Active NPI

Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
National Provider Identifier
1588095657
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
702 Issued in CT
Legal business name
INTERCOMMUNITY, INC.
Practice address
281 Main St
East Hartford, CT 06118-1823
Phone
(860) 569-5900
NPI assigned
Nov 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Kimberly L Beauregard, LCSW
Title
President & Ceo
Phone
(860) 291-1340

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 702 CT Primary
Primary Care Clinic/Center 261QP2300X 702 CT

Addresses

Primary practice location

281 Main St
East Hartford, CT 06118-1823

Mailing address

281 Main St
East Hartford, CT 06118-1823
Phone (860) 569-5900

Other identifiers 1

IdentifierTypeStateIssuer
008047966MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
Intercommunity Mental H6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1588095657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181823",
            "telephone_number": "860-569-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181823",
            "telephone_number": "860-569-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "BEAUREGARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "860-291-1340",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "702",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008047966",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.