NPIMap

Organization Active NPI

Medexpress Primary Care Texas, P.a.

  • General Practice Physician
  • Hartford, CT
National Provider Identifier
1669029773
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEDEXPRESS PRIMARY CARE TEXAS, P.A.
Practice address
185 Asylum Street
City Place 1
Hartford, CT 06103-3408
Phone
(952) 205-1252
NPI assigned
Aug 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Brett Gall
Title
Director Payor Contracting
Phone
(304) 225-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

185 Asylum Street
City Place 1
Hartford, CT 06103-3408

Mailing address

1001 Consol Energy Dr
Canonsburg, PA 15317-6506
Phone (304) 225-2500

Other names 1

  • The Well - Hartford Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medexpress Primary Care Texas PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

185 Asylum St
Ste 1
Hartford, CT 06103
Phone (952) 205-1252

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1669029773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 ASYLUM STREET",
            "address_2": "CITY PLACE 1",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061033408",
            "telephone_number": "952-205-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS PRIMARY CARE TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIRECTOR PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Well - Hartford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.