NPIMap

Organization Active NPI

Joint Pain Treatment Center, LLC

  • Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1760172001
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
JOINT PAIN TREATMENT CENTER, LLC
Practice address
417 Highland Ave
Waterbury, CT 06708-3454
Phone
(203) 504-7518
NPI assigned
May 10, 2023
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Kristen Donohue, NP
Title
Owner, NP Director
Phone
(203) 895-6572

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

417 Highland Ave
Waterbury, CT 06708-3454

Mailing address

417 Highland Ave
Waterbury, CT 06708-3454
Phone (203) 504-7518

Other practice location 1

10 Progress Dr Ste 2F
Shelton, CT 06484-6294
Phone (203) 504-7518

National Provider Directory

National Provider Directory

Locations

10 Progress Dr
Ste 2F
Shelton, CT 06484
Phone (203) 278-6394

Practitioners & affiliated clinicians

Practitioners 7

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": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1760172001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HIGHLAND AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083454",
            "telephone_number": "203-504-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HIGHLAND AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083454",
            "telephone_number": "203-504-7518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Progress Dr Ste 2F",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846294",
            "country_code": "US",
            "telephone_number": "203-504-7518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOINT PAIN TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER, NP DIRECTOR",
        "authorized_official_telephone_number": "203-895-6572",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.