NPIMap

Organization Active NPI

Michael Scanlon

Doing business as Glastonbury Podiatry Group

  • Podiatrist
  • Willimantic, CT
National Provider Identifier
1669529954
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MICHAEL SCANLON
Doing business as
Glastonbury Podiatry Group
Practice address
162 Mansfield Ave # a
Willimantic, CT 06226-2041
Phone
(860) 456-4250
NPI assigned
Jan 5, 2007
Organization subpart
Yes
Parent organization
MICHAEL SCANLONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Dr. Michael James Scanlon, DPMNPI 1447250352
Title
Physician/Owner
Phone
(860) 657-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

162 Mansfield Ave # a
Willimantic, CT 06226-2041

Mailing address

196 Parkway S
Suite 304
Waterford, CT 06385-1234
Phone (486) 044-2702

Other names 1

  • Glastonbury Podiatry Group Doing business as

National Provider Directory

National Provider Directory
Part of
Karla Scanlon DPM

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1669529954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 304",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "486-044-2702",
            "fax_number": "860-444-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MANSFIELD AVE # A",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-456-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SCANLON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHAEL SCANLON",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "SCANLON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "860-657-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glastonbury Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.