NPIMap

Organization Active NPI

Windham Community Memorial Hospital

  • Critical Care Neonatal Nurse Practitioner
  • Willimantic, CT
National Provider Identifier
1629475371
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
Legal business name
WINDHAM COMMUNITY MEMORIAL HOSPITAL
Practice address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone
(860) 456-6752
Fax
(203) 265-4557
NPI assigned
Nov 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Janice M Mackie
Title
Financial Officer
Phone
(860) 425-8755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LN0005X Primary

Addresses

Primary practice location

112 Mansfield Ave
Willimantic, CT 06226-2045

Mailing address

PO Box 4131
Yalesville, CT 06492-1481
Phone (203) 284-1340

National Provider Directory

National Provider Directory
Tax ID family
Windham Community Memorial Hospital6 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": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1629475371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4131",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064921481",
            "telephone_number": "203-284-1340",
            "fax_number": "203-265-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-456-6752",
            "fax_number": "203-265-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "MACKIE",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-425-8755"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.