Individual provider Active NPI

Colleen Mary Casey, D. O.

  • Family Medicine Physician
  • Norwich, CT
National Provider Identifier
1902885338
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
000221 Issued in CT
Practice address
330 Washington St
Suite 510
Norwich, CT 06360-2700
Phone
(860) 885-1308
Fax
(860) 889-1982
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 000221 CT Primary

Addresses

Primary practice location

330 Washington St
Suite 510
Norwich, CT 06360-2700

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

Other identifiers 1

IdentifierTypeStateIssuer
008010916MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060223000454 CT Practitioner - Family Practice 6901812205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
000221CTMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1902885338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WASHINGTON ST",
            "address_2": "SUITE 510",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602700",
            "telephone_number": "860-885-1308",
            "fax_number": "860-889-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "000221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008010916",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.