Individual provider Active NPI

Anne H Flitcraft, M.D.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Hartford, CT
National Provider Identifier
1891705315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
026794 Issued in CT
Practice address
131 Coventry Street
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112
Phone
(860) 714-3690
Fax
(860) 714-8683
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 026794 CT Primary

Addresses

Primary practice location

131 Coventry Street
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112

Mailing address

131 Coventry Street
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112
Phone (860) 714-3690

Other identifiers 2

IdentifierTypeStateIssuer
001267947MedicaidCT
10447314OtherCTCAQH ID #

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

LicenseStateTypeSpecialty
026794CTMDNeuromusculoskeletal Medicine & OMM Physician

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891705315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COVENTRY STREET",
            "address_2": "BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-714-3690",
            "fax_number": "860-714-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 COVENTRY STREET",
            "address_2": "BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-714-3690",
            "fax_number": "860-714-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLITCRAFT",
        "first_name": "ANNE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CT",
            "license": "026794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001267947",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID #",
            "identifier": "10447314",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.