Spectrum Healthcare Hartford, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2286 Issued in CT

Legal business name

SPECTRUM HEALTHCARE HARTFORD, LLC

Practice address

5 Greenwood St
Hartford, CT 06106-2110

Phone

(860) 871-5454

Fax

(860) 871-5757

NPI assigned

Nov 7, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Howard William Dickstein, PHD

Title

Chief Executive Officer

Phone

(860) 871-5454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Place Health Center Doing business as

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1689655896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREENWOOD ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062110",
            "telephone_number": "860-871-5454",
            "fax_number": "860-871-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GREENWOOD ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062110",
            "telephone_number": "860-871-5454",
            "fax_number": "860-871-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTHCARE HARTFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "DICKSTEIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "860-871-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000020081",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Southwick, PA-C
• Jessica Spadoni
• Juliana M Spagnuolo, PA-C
• Lindsey Lee Spann
• Jeffrey Peter Spear, MD
• Novelette Spence, LCSW
• Mark Spencer, MD
• SPH2 Enterprise, LLC
• Timothy A Spichiger, DO
• Linda M Spiegel, APRN BC

• All providers in Hartford, CT
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.