Active NPI
John James Walsh, MD-PHD
- Student in an Organized Health Care Education/Training Program
- Waterbury, CT
National Provider Identifier
1649920760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 06-0646844
- Practice address
- 56 Franklin St Ste 1
Waterbury, CT 06706-1281 - Phone
- (203) 709-6000
- NPI assigned
- Mar 24, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 06-0646844 | CT | Primary |
Addresses
Primary practice location
56 Franklin St Ste 1
Waterbury, CT 06706-1281
Mailing address
670 Ellsworth Ave
New Haven, CT 06511-1636
Phone (941) 538-8091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06-0646844 | CT | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1649920760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 ELLSWORTH AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065111636",
"telephone_number": "941-538-8091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 FRANKLIN ST STE 1",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067061281",
"telephone_number": "203-709-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "JOHN",
"middle_name": "JAMES",
"credential": "MD-PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "06-0646844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.