United States Navy

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Legal business name

UNITED STATES NAVY

Practice address

1 Crystal Lake Rd
BLDG 159 Naval Undersea Medical Inst. Navsubase Nlon
Groton, CT 06349-2300

Phone

(860) 694-6483

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James J Mucciarone, M.D.

Title

Commander / Oic Naval Undersea Med

Phone

(860) 694-6483

Specialties & licenses 1

Addresses

Tax ID family

Nmcsd63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Naval Branch Health Clinic New England

  • Health Service Clinic/Center
  • Groton, CT
  • NPI 1265780936
  NPD tax ID
• Usn

  • Military Hospital
  • Groton, CT
  • NPI 1932460086
  NPD tax ID

Locations

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1962959478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CRYSTAL LAKE ROAD",
            "address_2": "BLDG 159 NAVAL UNDERSEA MEDICAL INST. NAVSUBASE NLON",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CRYSTAL LAKE RD",
            "address_2": "BLDG 159 NAVAL UNDERSEA MEDICAL INST. NAVSUBASE NLON",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063492300",
            "telephone_number": "860-694-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATES NAVY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "MUCCIARONE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COMMANDER / OIC NAVAL UNDERSEA MED",
        "authorized_official_telephone_number": "860-694-6483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Thomas Turick, DMD
• Susan M. Turley, MS APRN
• U.S. Navy
• Roy L Underwood, SFIDC
• United Community and Family Services
• Urgent Care of Groton, LLC
• US Navy
• Usn
• Brittany Lee Valentine, LCSW
• Peggy B. Van Der Swaagh, LMFT

• Independent Duty Corpsman in Groton, CT
• Providers in Groton, CT by specialty
• Independent Duty Corpsman in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.