Organization Active NPI

Southbury Health Group LLC

  • Skilled Nursing Facility
  • Southbury, CT
National Provider Identifier
1851900609
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTHBURY HEALTH GROUP LLC
Practice address
990 Main St N
Southbury, CT 06488-1267
Phone
(203) 264-9135
Fax
(203) 262-6714
NPI assigned
Jul 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Ms. Brodie Bozadjian
Title
Partner
Phone
(857) 636-0005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

990 Main St N
Southbury, CT 06488-1267

Mailing address

990 Main St N
Southbury, CT 06488-1267
Phone (203) 264-9135

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1851900609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 MAIN ST N",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064881267",
            "telephone_number": "203-264-9135",
            "fax_number": "203-262-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 MAIN ST N",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064881267",
            "telephone_number": "203-264-9135",
            "fax_number": "203-262-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBURY HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "BOZADJIAN",
        "authorized_official_first_name": "BRODIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "857-636-0005",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.