Organization Active NPI

Med East Associates LLC

  • Internal Medicine Physician
  • Willimantic, CT
National Provider Identifier
1649256389
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MED EAST ASSOCIATES LLC
Practice address
1703 Main St
Willimantic, CT 06226-1133
Phone
(860) 456-1252
Fax
(860) 456-2278
NPI assigned
Dec 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Ms. Marie A Hakmiller, NA
Title
Administrator
Phone
(860) 456-1252

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Urgent Care Clinic/Center 261QU0200X NA

Addresses

Primary practice location

1703 Main St
Willimantic, CT 06226-1133

Mailing address

1703 Main St
Willimantic, CT 06226-1133
Phone (860) 456-1252

Other identifiers 1

IdentifierTypeStateIssuer
004088755MedicaidCT

Other names 1

  • MED EAST MEDICAL WALK IN CENTER Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1649256389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261133",
            "telephone_number": "860-456-1252",
            "fax_number": "860-456-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261133",
            "telephone_number": "860-456-1252",
            "fax_number": "860-456-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED EAST ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "HAKMILLER",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-456-1252",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": "NA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004088755",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MED EAST MEDICAL WALK IN CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 19, 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.