MHS Primary Care Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MHS PRIMARY CARE INC.

Practice address

27 Commerce St
Clinton, CT 06413-2054

Phone

(860) 669-8659

Fax

(860) 669-4382

NPI assigned

Dec 10, 2014

Organization subpart

No

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

Authorized official

Name

Susan Serkey

Title

Network Executive

Phone

(860) 358-4802

Specialties & licenses 4

Addresses

Other identifiers 3

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1760880595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4820",
            "fax_number": "860-358-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 COMMERCE ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132054",
            "telephone_number": "860-669-8659",
            "fax_number": "860-669-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHS PRIMARY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "SERKEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NETWORK EXECUTIVE",
        "authorized_official_telephone_number": "860-358-4802"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004181343",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004173259",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004201084",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa McComiskey, OT
• Timothy Earle McDevitt, RPH
• Meditox Care, LLC
• Kaitlyn Paige Melino, LPC
• Caryn Mello-Kennedy
• Michael Dental of Clinton, LLC
• Stacey Christine Michael, D.M.D.
• James Stephen Milone, D.C.
• MLZ Health Care Associates, LLC
• Regina Moller

• All providers in Clinton, CT
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.