NPIMap

Organization Active NPI

State of Connecticut

  • General Acute Care Hospital
  • Farmington, CT
National Provider Identifier
1669466561
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00065 Issued in CT
Legal business name
STATE OF CONNECTICUT
Practice address
263 Farmington Avenue
Farmington, CT 06030-5355
Phone
(860) 679-2916
Fax
(860) 679-3071
NPI assigned
Sep 7, 2005
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Jeffrey Geoghegan
Title
Chief Financial Officer
Phone
(860) 679-3162

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 00065 CT
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 00065 CT
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 00065 CT
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X CT
Emergency Care Clinic/Center 261QE0002X 00065 CT
General Acute Care Hospital 282N00000X 00065 CT Primary

Addresses

Primary practice location

263 Farmington Avenue
Farmington, CT 06030-5355

Mailing address

263 Farmington Avenue
Farmington, CT 06030-5355

Other names 1

  • John Dempsey Hospital Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041122000596 CT Part B Supplier - Clinic/Group Practice 8022915677 Receives reassigned benefits from 215 practitioners
1 other NPI on this enrollment
Practice locations: Storrs, CT; Farmington, CT
O20061229000009 CT Part A Provider - Hospital 8022915677 1 other NPI on this enrollment
Practice locations: West Hartford, CT; Storrs Mansfield, CT; Storrs, CT; Farmington, CT; Southington, CT; Simsbury, CT; Middletown, CT; Bristol, CT…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669466561. Details of each certification follow.

Hospital certification: CCN 070036

Legal name
STATE OF CONNECTICUT
Doing business as
JOHN DEMPSEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1967
Last certification
Sep 6, 2008
Beds
204
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1966 in CT
Enrollment address
263 Farmington Ave
Farmington, CT 60305355
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
John Dempsey Hospital of the University of ConnectCCN 070036 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

117 Albany Tpke
Canton, CT 06019
Phone (860) 658-3444

263 Farmington Ave
#6305
Farmington, CT 06030
Phone (860) 282-4137

1 Royce Cir
Ste 104
Storrs Mansfield, CT 06268
Phone (860) 487-9200

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Chad a Bianci Individual Corporate DirectorController Apr 3, 2015
Savitri Appiah Individual Corporate Director Aug 31, 2007
Jeffrey P Geoghegan Individual Corporate OfficerChief Financial Officer Oct 1, 2013 100%
Operational/Managerial ControlChief Financial Officer Oct 1, 2013 100%
State of Connecticut Organization, Farmington, CT Operational/Managerial Control Jul 1, 1966 100%
Andrew C Agwunobi Individual Corporate OfficerCeo May 29, 2024 100%
Corporate DirectorCeo May 29, 2024 100%
W-2 Managing EmployeeCeo May 29, 2024 100%
Bruce T Liang Individual Operational/Managerial ControlCeo Feb 12, 2022 100%

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Albert J. Solnit Children's Center - South CampusMiddletown, CT, CCN 074015 Hospital Operational/Managerial Control (100%) Jun 1, 2011
Conneticut Valley HospitalHartford, CT, CCN 074003 Hospital Operational/Managerial Control Mar 30, 2015
Connecticut Mental Health CenterNew Haven, CT, CCN 074011 Hospital Operational/Managerial Control Mar 30, 2015
Southwest Connecticut Mental Health System (Swcmhs)Bridgeport, CT, CCN 074012 Hospital Operational/Managerial Control May 2, 1988
John L. Levitow Health Care CenterRocky Hill, CT, CCN 075443 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Mar 4, 2020
Jan 1, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 225

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.

View all 225

Affiliated clinicians 784

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 784

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1669466561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060305355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060305355",
            "telephone_number": "860-679-2916",
            "fax_number": "860-679-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-05-04",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "GEOGHEGAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-679-3162"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "00065",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CT",
            "license": "00065",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "00065",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "CT",
            "license": "00065",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CT",
            "license": "00065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John Dempsey Hospital",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "John Dempsey Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.