NPIMap

Organization Active NPI

Mauks Koepke Medical LLC

  • Specialist
  • Danbury, CT
National Provider Identifier
1831185248
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MAUKS KOEPKE MEDICAL LLC
Practice address
57 North St
Suite # 309-310
Danbury, CT 06810-5660
Phone
(203) 794-0761
Fax
(203) 731-5399
NPI assigned
Sep 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Katherine Roy, BBA, MBA
Title
Office Manager
Phone
(203) 743-4168

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X CT Primary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X CT
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X CT
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CT
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X CT

Addresses

Primary practice location

57 North St
Suite # 309-310
Danbury, CT 06810-5660

Mailing address

57 North St
Suite # 309-310
Danbury, CT 06810-5660
Phone (203) 794-0761

Other identifiers 3

IdentifierTypeStateIssuer
P2879962OtherCTOXFORD
2V4400OtherCTHEALTHNET
3188644OtherCTAETNA

National Provider Directory

National Provider Directory

Locations

57 North St
Ste 309310
Danbury, CT 06810
Phone (203) 794-0761

57 North St
Ste 309
Danbury, CT 06810
Phone (203) 794-0761

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831185248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 NORTH ST",
            "address_2": "SUITE # 309-310",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105660",
            "telephone_number": "203-794-0761",
            "fax_number": "203-731-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 NORTH ST",
            "address_2": "SUITE # 309-310",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105660",
            "telephone_number": "203-794-0761",
            "fax_number": "203-731-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUKS KOEPKE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-743-4168",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BBA, MBA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2879962",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V4400",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3188644",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.