NPIMap

Organization Active NPI

Podiatry Associates of Waterbury PC

  • Podiatrist
  • Waterbury, CT
National Provider Identifier
1891970331
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000227 Issued in CT
Legal business name
PODIATRY ASSOCIATES OF WATERBURY PC
Practice address
80 Phoenix Ave
Suite 204
Waterbury, CT 06702-1418
Phone
(203) 754-4247
Fax
(203) 757-8772
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Authorized official

Name
Thomas W Winters, DPM
Title
President/Owner
Phone
(203) 754-4247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 000227 CT Primary

Addresses

Primary practice location

80 Phoenix Ave
Suite 204
Waterbury, CT 06702-1418

Mailing address

PO Box 2657
Ponte Vedra Beach, FL 32004-2657
Phone (203) 206-9700

Other identifiers 7

IdentifierTypeStateIssuer
OV7691OtherHEALTHNET
706363OtherCONNECTICARE
NHS333OtherOXFORD HEALTH PLANS
355659OtherWELLCARE
4086022MedicaidCT
0051391OtherAETNA
030000227CT01OtherANTHEM BLUE CROSS

National Provider Directory

National Provider Directory

Locations

80 Phoenix Ave
Ste 204
Waterbury, CT 06702
Phone (203) 754-4247

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1891970331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2657",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320042657",
            "telephone_number": "203-206-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PHOENIX AVE",
            "address_2": "SUITE 204",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021418",
            "telephone_number": "203-754-4247",
            "fax_number": "203-757-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF WATERBURY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "203-754-4247",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OV7691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "706363",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "NHS333",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "355659",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4086022",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0051391",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "030000227CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.