Campbell Medical Care, LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

005055 Issued in CT

Legal business name

CAMPBELL MEDICAL CARE, LLC

Practice address

22 Parkwood Dr
Windsor, CT 06095-3142

Phone

(860) 810-2943

Fax

(860) 687-0887

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Annetta R Troche, APRN

Title

Owner

Phone

(860) 810-2943

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1891247805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PARKWOOD DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953142",
            "telephone_number": "860-810-2943",
            "fax_number": "860-687-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PARKWOOD DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953142",
            "telephone_number": "860-810-2943",
            "fax_number": "860-687-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL MEDICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "TROCHE",
        "authorized_official_first_name": "ANNETTA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-810-2943",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "005055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Cadman, PA-C
• Amanda Calderoni, BCBA
• Paulette D. Caldwell, MSW
• Cassandra Caliciotti, OTD, OTR/L
• Patrickbon Cambel, CPHT
• Courtney Campbell
• Korin Campbell, LCSW
• Katherine Campoli, BS
• Tara Lynne Cange
• Danielle Canning, PA-C

• Gerontology Nurse Practitioner in Windsor, CT
• Providers in Windsor, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.