Resilient Living PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

030589 Issued in CT

Legal business name

RESILIENT LIVING PC

Practice address

1261 S Main St
Plantsville, CT 06479-1750

Phone

(860) 628-9000

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Anne M Kenny, MD

Title

Physician

Phone

(860) 628-9000

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1821537648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791750",
            "telephone_number": "860-628-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791750",
            "telephone_number": "860-628-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT LIVING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "860-628-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "030589",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CT",
            "license": "030589",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043293780",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Katherine Puzio, MSOT, OTRL/L
• Jonathan Rauch
• Rebecca Stamat
• Ben C. Reilly, DC
• Greg E Reiss, DMD
• Trinity Robinson-Wise, LPN
• Kris Anthony Robles, LCSW
• Suzanne A Rosenberg, LCSW
• Erika Stacey Ross, LCSW
• Kristin Rouse, LCSW

• Geriatric Medicine (Internal Medicine) Physician in Plantsville, CT
• Providers in Plantsville, CT by specialty
• Geriatric Medicine (Internal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.