NPIMap

Organization Active NPI

Yale New Haven Hospital

  • Registered Dietitian
  • Guilford, CT
National Provider Identifier
1891918850
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000582 Issued in CT
Legal business name
YALE NEW HAVEN HOSPITAL
Practice address
111 Goose LN
Office #1806
Guilford, CT 06437-5101
Phone
(203) 453-7199
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Douglas Payne
Title
Director of Reimbursement
Phone
(203) 688-4878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000582 CT Primary

Addresses

Primary practice location

111 Goose LN
Office #1806
Guilford, CT 06437-5101

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 688-2422

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D1026188Yale New Haven Hospital111 Goose Lane, Ground Floor, Guilford, CT 06437Certificate of waiverJul 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Yale-New Haven Hospital23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

111 Goose Ln
Ofc 1806
Guilford, CT 06437
Phone (203) 453-7199

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891918850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GOOSE LN",
            "address_2": "OFFICE #1806",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064375101",
            "telephone_number": "203-453-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YALE NEW HAVEN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "203-688-4878"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.