Individual provider Active NPI

Violet Pastorkova-Jaouen

  • Registered Dietitian
  • Middlebury, CT
National Provider Identifier
1679077754
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
998 Issued in CT
Practice address
1625 Straits Tpke Ste 200
Middlebury, CT 06762-1836
Phone
(203) 758-1004
Fax
(203) 575-2151
NPI assigned
Mar 22, 2018
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 998 CT Primary

Addresses

Primary practice location

1625 Straits Tpke Ste 200
Middlebury, CT 06762-1836

Mailing address

1625 Straits Tpke Ste 211
Middlebury, CT 06762-1836
Phone (203) 573-9512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180515000687 CT Practitioner - Registered Dietitian Or Nutrition Professional 7012271307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

40 Hart St
New Britain, CT 06052-1759
Phone (860) 793-3500

855 Lakewood Rd
Waterbury, CT 06704-5408
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Wheeler Clinic Inc CurrentSince Oct 21, 2024 Accepting new patients
Wheeler Clinic Inc CurrentSince Oct 21, 2024 Accepting new patients
Alliance Medical Group, Inc Dietitian, Registered Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1625 Straits Tpke
Ste 200
Middlebury, CT 06762
Phone (203) 568-2929

1625 Straits Tpke
Ste 211
Middlebury, CT 06762
Phone (203) 573-9512

91 Northwest Dr
Plainville, CT 06062
Phone (860) 793-3871

Interoperability endpoints

  • Direct secure messaging: violet.pastorkovajaouen.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1679077754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE STE 211",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-573-9512",
            "fax_number": "203-575-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE STE 200",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-1004",
            "fax_number": "203-575-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTORKOVA-JAOUEN",
        "first_name": "VIOLET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.