NPIMap

Organization Active NPI

Madison Pediatrics LLC

  • Pediatrics Physician
  • Madison, CT
National Provider Identifier
1740465780
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MADISON PEDIATRICS LLC
Practice address
105 Wall St
Madison, CT 06443-3120
Phone
(203) 245-7341
Fax
(203) 245-0530
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Dr. Dia B Flanagan, MDNPI 1184720609
Title
Managing Member
Phone
(203) 245-7341

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

105 Wall St
Madison, CT 06443-3120

Mailing address

105 Wall St
Madison, CT 06443-3120
Phone (203) 245-7341

National Provider Directory

National Provider Directory

Locations

105 Wall St
Madison, CT 06443
Phone (203) 245-7341

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1740465780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433120",
            "telephone_number": "203-245-7341",
            "fax_number": "203-245-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433120",
            "telephone_number": "203-245-7341",
            "fax_number": "203-245-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "DIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "203-245-7341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.