Active NPI
Jose Leonardo Villa Uribe
- Emergency Medicine Physician
- Wallingford, CT
National Provider Identifier
1891180246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 1.059957
- Practice address
- 900 Northrop Rd
Wallingford, CT 06492 - Phone
- (203) 294-9153
- NPI assigned
- Apr 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 1.059957 | CT | Primary |
Addresses
Primary practice location
900 Northrop Rd
Wallingford, CT 06492
Mailing address
900 Northrop Rd
Wallingford, CT 06492-1997
Phone (203) 949-1534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1.059957 | CT | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1891180246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 NORTHROP RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064921997",
"telephone_number": "203-949-1534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 NORTHROP RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-294-9153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLA URIBE",
"first_name": "JOSE",
"middle_name": "LEONARDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-02",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "CT",
"license": "1.059957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.