West Hartford Primary Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WEST HARTFORD PRIMARY CARE, LLC

Practice address

45 S Main St Ste 302
West Hartford, CT 06107-2402

Phone

(860) 698-3600

NPI assigned

Apr 14, 2020

Organization subpart

No

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

Authorized official

Name

Thomas Brown

Title

Sole Member

Phone

(860) 698-3600

Specialties & licenses 1

Addresses

Other names 1

• MentalWellnessMD Doing business as

Locations

Practitioners 2

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

• Marva Beckford, LCSW

  • Clinical Social Worker
  • Hartford, CT
  • NPI 1497995617
  NPD (past)
• Justin Mehl

  • Counselor
  • Springfield, MA
  • NPI 1366893638
  NPD (past)

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1609495134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST STE 302",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072402",
            "telephone_number": "860-698-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST STE 302",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072402",
            "telephone_number": "860-698-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HARTFORD PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "860-698-3600"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MentalWellnessMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Hartford Maxillofacial Surgery, PC
• West Hartford Medical Center
• West Hartford One Opco LLC
• West Hartford Pediatrics, LLC
• West Hartford Podiatry Associates PC
• West Hartford Therapy Center LLC
• Paul B West, M.D.
• Samantha Sarah West, MSW INTERN
• Westside Chiropractic LLC
• Ellen Wetherbee-McDevitt, PT

• Internal Medicine Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.