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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 11

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

Owned or controlled facilities with NPI records 6

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 10

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

Facilities with the same owner 5

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

Practitioners 378

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 378

Affiliated clinicians 784

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

View all 784

Care Compare: Hospital

Medicare Care Compare
Listed as
John Dempsey Hospital of the University of ConnectCCN 070036
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

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…

Hospital certification: CCN 070036

Medicare enrollment files
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

All disclosed owners & managing parties 6

Medicare enrollment files

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%

All facility ownership & control disclosures 5

Medicare enrollment files

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

National Provider Directory

National Provider Directory

Locations

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

1 Royce Cir
Ste 103
Storrs, CT 06268

Specialties & licenses 6

NPPES NPI Registry
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

NPPES NPI Registry

Primary practice location

263 Farmington Avenue
Farmington, CT 06030-5355

Mailing address

263 Farmington Avenue
Farmington, CT 06030-5355

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4041968MedicaidCT

Other names 1

NPPES NPI Registry
  • John Dempsey Hospital Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 4, 2023.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4041968",
            "state": "CT"
        }
    ],
    "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.