NPIMap

Organization Active NPI

Innovative Healthcare

  • Exclusive Provider Organization
  • Woodbridge, CT
National Provider Identifier
1629383906
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
302F00000X Issued in CT
Legal business name
INNOVATIVE HEALTHCARE
Practice address
555 Amity Rd.
Woodbridge, CT 06525
Phone
(203) 687-9502
Fax
(203) 795-5645
NPI assigned
Aug 11, 2010
Last updated
Aug 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Janet M Berkley, RNNPI 1033691951
Title
Managing Member
Phone
(203) 687-9502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 302F00000X CT Primary

Addresses

Primary practice location

555 Amity Rd.
Woodbridge, CT 06525

Mailing address

325 Boston Post Rd.
#1E
Orange, CT 06477
Phone (203) 687-9502

National Provider Directory

National Provider Directory

Locations

325 Boston Post Rd
Ste 1E
Orange, CT 06477

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIFDD

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1629383906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BOSTON POST RD.",
            "address_2": "#1E",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "06477",
            "telephone_number": "203-687-9502",
            "fax_number": "203-795-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 AMITY RD.",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-687-9502",
            "fax_number": "203-795-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "BERKLEY",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "203-687-9502",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CT",
            "license": "302F00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.