Edward McDermott, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20822 Issued in CT

Legal business name

EDWARD MCDERMOTT, MD

Practice address

276R Montauk Ave
New London, CT 06320

Phone

(860) 447-1475

Fax

(860) 447-8598

NPI assigned

Mar 7, 2007

Last updated

Nov 17, 2008By 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 J McDermott, MDNPI 1356324008

Title

Owner

Phone

(860) 447-1475

Specialties & licenses 1

Addresses

Other identifiers 4

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

  • Nurse Practitioner
  • New London, CT
  • NPI 1518090976
  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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1629109467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276R MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-447-1475",
            "fax_number": "860-447-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276R MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-447-1475",
            "fax_number": "860-447-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD MCDERMOTT, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-447-1475",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "20822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB1041",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "010020822CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "030963",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001208222",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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.
• Virginie Eklund

• Internal Medicine Physician in New London, CT
• Providers in New London, 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 Nov 17, 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.