NPIMap

Organization Active NPI

CT Optimal Wellness, LLC

  • Primary Care Clinic/Center
  • Hartford, CT
National Provider Identifier
1770014656
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
52588 Issued in CT
Legal business name
CT OPTIMAL WELLNESS, LLC
Practice address
100 Pearl St
12 Floor
Hartford, CT 06103
Phone
(860) 725-0025
NPI assigned
Mar 23, 2017
Organization subpart
No

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
CT Optimal Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Pearl St
Fl 12
Hartford, CT 06103
Phone (860) 725-0025

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Jennifer Sirch
Title
Manager
Phone
(203) 215-9179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 52588 CT Primary

Addresses

Primary practice location

100 Pearl St
12 Floor
Hartford, CT 06103

Mailing address

124 W 60TH Street
Suite 35D
New York, NY 10023

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1770014656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 60TH STREET",
            "address_2": "SUITE 35D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEARL ST",
            "address_2": "12 FLOOR",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06103",
            "telephone_number": "860-725-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT OPTIMAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "SIRCH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-215-9179"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "52588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.