Pride Comprehensive Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRIDE COMPREHENSIVE PRIMARY CARE LLC

Practice address

7 Warren Rd
Wolcott, CT 06716-3015

Phone

(414) 614-5832

NPI assigned

Feb 6, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Jurg W. J. Oggenfuss, APRN, FNP-BC, ANP-BC

Title

Chief Medical Officer

Phone

(414) 614-5832

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1699307751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WARREN RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067163015",
            "telephone_number": "414-614-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WARREN RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067163015",
            "telephone_number": "414-614-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE COMPREHENSIVE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "OGGENFUSS",
        "authorized_official_first_name": "JURG",
        "authorized_official_middle_name": "W. J.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "414-614-5832",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN, FNP-BC, ANP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Pawson, DC
• Taylor Elizabeth Pearsall, ATC
• Peter Giacomazzi, MD,LLC
• Diane M Phipps, OT ASSISTANT
• Sandra Porteus, LCSW
• Pure Essence Center for Wellness and Aesthetics
• R & R MD PC
• Marc N Raad, M.D.
• Ray of Hope Homecare LLC
• Reliant Angels Homecare LLC

• Primary Care Clinic/Center in Wolcott, CT
• Providers in Wolcott, CT by specialty
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.