Bethel Medical Group, P. C.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

016412 Issued in CT

Legal business name

BETHEL MEDICAL GROUP, P. C.

Practice address

155 Greenwood Ave
Bethel, CT 06801-2527

Phone

(203) 744-1639

Fax

(203) 748-1202

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Shapiro, M. D.

Title

Vice-President

Phone

(203) 744-1639

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1942400049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GREENWOOD AVE",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012527",
            "telephone_number": "203-744-1639",
            "fax_number": "203-748-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GREENWOOD AVE",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012527",
            "telephone_number": "203-744-1639",
            "fax_number": "203-748-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL MEDICAL GROUP, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "203-744-1639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CT",
            "license": "016412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Bethel, CT
• Providers in Bethel, CT by specialty
• Adult Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.