NPIMap

Organization Active NPI

Greater Hartford Nephrology, LLC

  • Nephrology Physician
  • Bloomfield, CT
National Provider Identifier
1750388260
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
GREATER HARTFORD NEPHROLOGY, LLC
Practice address
701 Cottage Grove Rd
Suite B-220
Bloomfield, CT 06002-3080
Phone
(860) 769-9866
Fax
(860) 769-7300
NPI assigned
Jun 30, 2005
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Ms. Nikki Foran, BS
Title
Practice Manager
Phone
(860) 769-9866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

701 Cottage Grove Rd
Suite B-220
Bloomfield, CT 06002-3080

Mailing address

701 Cottage Grove Rd
Suite B-220
Bloomfield, CT 06002-3080
Phone (860) 769-9866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000406 CT Part B Supplier - Clinic/Group Practice 5991772212 Receives reassigned benefits from 9 practitioners
Practice locations: Bloomfield, CT; Enfield, CT; Glastonbury, CT

National Provider Directory

National Provider Directory

Locations

35 Jolley Dr
Ste 203
Bloomfield, CT 06002
Phone (860) 769-7302

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1750388260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD",
            "address_2": "SUITE B-220",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023080",
            "telephone_number": "860-769-9866",
            "fax_number": "860-769-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD",
            "address_2": "SUITE B-220",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023080",
            "telephone_number": "860-769-9866",
            "fax_number": "860-769-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER HARTFORD NEPHROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "FORAN",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "860-769-9866",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.