NPIMap

Organization Active NPI

Family Medicine Center

  • Medical Physician Assistant
  • Manchester, CT
National Provider Identifier
1730566381
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3317 Issued in CT
Legal business name
FAMILY MEDICINE CENTER
Doing business as
FAMILY MEDICINE CENTER
Practice address
574 Middle Tpke E
Manchester, CT 06040-3730
Phone
(860) 646-4334
Fax
(860) 646-7020
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Denise L. Macleod
Title
Office Manager
Phone
(860) 573-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 3317 CT Primary

Addresses

Primary practice location

574 Middle Tpke E
Manchester, CT 06040-3730

Mailing address

574 Middle Tpke E
Manchester, CT 06040-3730
Phone (860) 646-4334

Other names 1

  • FAMILY MEDICINE CENTER Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1730566381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 MIDDLE TPKE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403730",
            "telephone_number": "860-646-4334",
            "fax_number": "860-646-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 MIDDLE TPKE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403730",
            "telephone_number": "860-646-4334",
            "fax_number": "860-646-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "MACLEOD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-573-2900"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.