Avtandil Kochiashvili

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Gengras Clinic at St Francis Hospital
1000 Asylum Anenue
Hartford, CT 06105

Phone

(860) 714-4532

Fax

(860) 714-8275

NPI assigned

Jun 2, 2022

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: akochiashvili2388338@direct.trinity-health.org

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1952040354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENGRAS CLINIC AT ST FRANCIS HOSPITAL",
            "address_2": "1000 ASYLUM ANENUE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-4532",
            "fax_number": "860-714-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GENGRAS CLINIC AT ST FRANCIS HOSPITAL",
            "address_2": "1000 ASYLUM ANENUE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-714-4532",
            "fax_number": "860-714-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHIASHVILI",
        "first_name": "AVTANDIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Ann Knox
• Christine Fitzgerald Knudsen, APRN
• Sarah Kobaisi, M.D.
• Barbara Koblenz, MD
• Danielle Gayle Koby, PHD
• Karen Jeanne-Dare Koenig, APRN
• Carly Ann Koerner, CRNA
• Krista Koerner, CRNA
• Linda Koflanovich, LCSW
• Jennifer Kokalari, PA-C

• Student in an Organized Health Care Education/Training Program in Hartford, CT
• Providers in Hartford, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.