Windham Surgical Group, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

WINDHAM SURGICAL GROUP, P.C.

Practice address

162 Mansfield Ave # B
Willimantic, CT 06226-2041

Phone

(860) 423-5000

Fax

(860) 423-4838

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Herbert W. Ridyard Jr., M.D.

Title

President

Phone

(860) 423-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1609806397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 MANSFIELD AVE # B",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-423-5000",
            "fax_number": "860-423-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MANSFIELD AVE # B",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-423-5000",
            "fax_number": "860-423-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM SURGICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "RIDYARD",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-423-5000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004139318",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Windham Family Medical Services, PC
• Windham Gi, LLC
• Windham Health & Rehab LLC
• Windham Medical Group
• Windham Radiology Associates
• Windham Urology Group, PC
• Kayla Winshman, OD
• Dana Wiseman, M.D.
• Anthea Fiona Woodley, MD
• Dana Phillip Woods, MD

• Specialist in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.