Connecticut Osteopathic Center

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

Legal business name

CONNECTICUT OSTEOPATHIC CENTER

Practice address

141 Dowd Ave
Canton, CT 06019-2401

Phone

(570) 498-4879

NPI assigned

Mar 22, 2022

Last updated

Mar 22, 2022By 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

Lisa Gronski, DONPI 1265758577

Title

Owner

Phone

(570) 498-4879

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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.

• Lisa Marie Gronski, D.O.

  • Internal Medicine Physician
  • Avon, CT
  • NPI 1265758577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1649929126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W. MAIN ST",
            "address_2": "SUITE 2, #135",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DOWD AVE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192401",
            "telephone_number": "570-498-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT OSTEOPATHIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "GRONSKI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-498-4879",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Reynolds Chilton, M.D.
• Judy Chiu, DO
• Collaborative Medicine LLC
• Connecticut CVS Pharmacy LLC (CVS Pharmacy# 02253)
• Connecticut Foot Specialists PC
• Brittany Corsetti, DPT
• Brenda Coyle, PH.D.
• Lauren Cremens, LPC
• Crescent Moon Care LLC
• Jeanne Marie Daubert, DPT

• Sports Medicine (Internal Medicine) Physician in Canton, CT
• Providers in Canton, CT by specialty
• Sports Medicine (Internal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.