NPIMap

Organization Active NPI

Lawrence and Memorial Hospital, Inc.

  • Land Ambulance
  • New London, CT
National Provider Identifier
1942536594
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
LAWRENCE AND MEMORIAL HOSPITAL, INC.
Practice address
365 Montauk Ave
New London, CT 06320-4700
Phone
(860) 444-5164
NPI assigned
Nov 2, 2009
Last updated
Aug 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Authorized official

Name
Ron Kersey
Title
EMS Coordinator
Phone
(860) 444-5764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320-4700

Mailing address

365 Montauk Ave
New London, CT 06320-4700

Other identifiers 3

IdentifierTypeStateIssuer
710C095P1CT01OtherCTANTHEM BLUE CROSS BLUE SHIELD
114428400OtherCTUS DEPT OF LABOR
Z09781OtherCTHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240320000331 CT Part B Supplier - Ambulance Service Supplier 5991792053 Practice locations: New London, CT

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sproul L7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

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": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1942536594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-444-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE AND MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "KERSEY",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "EMS COORDINATOR",
        "authorized_official_telephone_number": "860-444-5764"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "710C095P1CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "114428400",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "Z09781",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.