NPIMap

Organization Active NPI

Advanced Concussion Solutions LLC

  • Pediatrics Physician
  • Westport, CT
National Provider Identifier
1750872289
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
54943 Issued in CT
Legal business name
ADVANCED CONCUSSION SOLUTIONS LLC
Doing business as
Advanced Concussion Solutions LLC
Practice address
181 Post Rd W
Westport, CT 06880-4626
Phone
(203) 293-6325
Fax
(203) 286-1282
NPI assigned
May 21, 2018
Last updated
May 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Authorized official

Name
Dr. Audrey Paul, MD
Title
Medical Director
Phone
(203) 293-6325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54943 CT Primary

Addresses

Primary practice location

181 Post Rd W
Westport, CT 06880-4626

Mailing address

181 Post Rd W
Westport, CT 06880-4626
Phone (203) 293-6325

Other names 1

  • Advanced Concussion Solutions LLC 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": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1750872289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804626",
            "telephone_number": "203-293-6325",
            "fax_number": "203-286-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804626",
            "telephone_number": "203-293-6325",
            "fax_number": "203-286-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CONCUSSION SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-293-6325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "54943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Concussion Solutions LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.