Organization Active NPI

Center for Diabetes Excellence

  • Pediatric Endocrinology Physician
  • Monroe, CT
National Provider Identifier
1922500412
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
1425 Issued in CT
Legal business name
CENTER FOR DIABETES EXCELLENCE
Practice address
500 Purdy Hill Rd Ste 2
Monroe, CT 06468-1661
Phone
(203) 261-4277
NPI assigned
Mar 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Authorized official

Name
Joann Hickey Ahern, MSNNPI 1770566317
Title
Aprn
Phone
(203) 261-4277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0205X 1425 CT Primary
Clinic/Center 261Q00000X 1425 CT

Addresses

Primary practice location

500 Purdy Hill Rd Ste 2
Monroe, CT 06468-1661

Mailing address

530 Scenic Rd
Orange, CT 06477-2127
Phone (203) 909-0016

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
07D2151268Center for Diabetes Excellence500 Purdy Hill Rd, Monroe, CT 06468Certificate of waiverJul 16, 2028

National Provider Directory

National Provider Directory

Locations

500 Purdy Hill Rd
Monroe, CT 06468

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1922500412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SCENIC RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064772127",
            "telephone_number": "203-909-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PURDY HILL RD STE 2",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681661",
            "telephone_number": "203-261-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DIABETES EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "HICKEY",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "203-261-4277",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CT",
            "license": "1425",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CT",
            "license": "1425",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.