Individual provider Active NPI

Ronald A Fox, PA-C

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1922036821
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000021 Issued in CT
Practice address
60 Westwood Ave
Suite 104
Waterbury, CT 06708-2460
Phone
(203) 574-4930
Fax
(203) 574-5987
NPI assigned
Jun 29, 2006
Sex
Male
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
Medical Physician Assistant 363AM0700X 000021 CT Primary

Addresses

Primary practice location

60 Westwood Ave
Suite 104
Waterbury, CT 06708-2460

Mailing address

60 Westwood Ave
Suite 104
Waterbury, CT 06708-2460
Phone (203) 574-4930

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000021CTMDAthletic Trainer
21CTMDDoula

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922036821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 104",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-574-4930",
            "fax_number": "203-574-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 104",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-574-4930",
            "fax_number": "203-574-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "RONALD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000021",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.