NPIMap

Organization Active NPI

Southeastern CT Nephrology Assoc.

  • Adult Health Nurse Practitioner
  • Uncasville, CT
National Provider Identifier
1821426099
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
003528 Issued in CT
Legal business name
SOUTHEASTERN CT NEPHROLOGY ASSOC.
Practice address
88 Norwich New London Tpke
Suite 2
Uncasville, CT 06382-2518
Phone
(860) 367-0087
Fax
(860) 367-0117
NPI assigned
Oct 24, 2013
Last updated
Oct 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Authorized official

Name
Mr. Jay M. Ginsberg, M.D.NPI 1841285509
Title
President
Phone
(860) 367-0087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 003528 CT Primary

Addresses

Primary practice location

88 Norwich New London Tpke
Suite 2
Uncasville, CT 06382-2518

Mailing address

88 Norwich New London Tpke
Suite 2
Uncasville, CT 06382-2518
Phone (860) 367-0087

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0695738Southeastern CT Nephrology Assoc PC88 Norwich-New London Tpke, Suite 2, Uncasville, CT 06382Provider-performed microscopyApr 30, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1821426099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 NORWICH NEW LONDON TPKE",
            "address_2": "SUITE 2",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063822518",
            "telephone_number": "860-367-0087",
            "fax_number": "860-367-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 NORWICH NEW LONDON TPKE",
            "address_2": "SUITE 2",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063822518",
            "telephone_number": "860-367-0087",
            "fax_number": "860-367-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN CT NEPHROLOGY ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "GINSBERG",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-367-0087",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "003528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uncasville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.