University of Connecticut

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CL-0378 Issued in CT

Legal business name

UNIVERSITY OF CONNECTICUT

Practice address

234 Glenbrook Rd Unit 4011
Storrs, CT 06269-4011

Phone

(860) 486-0730

Fax

(860) 486-4076

NPI assigned

Mar 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Anderson, M.D.

Title

Medical Director

Phone

(860) 486-0765

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• UConn Student Health Lab Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

University of Connecticut8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• The University of Connecticut

  • Ambulance
  • Storrs, CT
  • NPI 1326036773
  NPD tax ID
• University of Connecticut

  • Audiologist
  • Storrs, CT
  • NPI 1114011830
  NPD tax ID
• University of Connecticut

  • Clinic Pharmacy
  • Storrs Mansfield, CT
  • NPI 1487788196
  NPD tax ID
• University of Connecticut

  • Child & Adolescent Psychiatry Physician
  • Storrs, CT
  • NPI 1851649222
  NPD tax ID
• University of Connecticut Health Science Center

  • Student in an Organized Health Care Education/Training Program
  • Farmington, CT
  • NPI 1477901163
  NPD tax ID
• University of Connecticut Student Health and Wellness

  • Student Health Clinic/Center
  • Storrs Mansfield, CT
  • NPI 1629097043
  NPD tax ID
• University of Connecticut-Division of Public Safety

  • Ambulance
  • Storrs, CT
  • NPI 1912080763
  NPD tax ID

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1972964989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 GLENBROOK RD UNIT 4011",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062694011",
            "telephone_number": "860-486-0730",
            "fax_number": "860-486-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GLENBROOK RD UNIT 4011",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062694011",
            "telephone_number": "860-486-0730",
            "fax_number": "860-486-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-486-0765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CT",
            "license": "CL-0378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "07D0716469",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABORATORY LICENSE",
            "identifier": "CL-0378",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UConn Student Health Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Translational Medicine Clinic & Research Center
• Zoe Trotta
• Damien Tyler, EMT-B
• University of Connecticut
• University of Connecticut
• University of Connecticut-Division of Public Safety
• Denise B Van Der Voort, MA
• Katherine Van Deveire, DPT, OCS
• Katharine Nicole Vardanian, MSN, APRN, FNP-BC
• Claire E Verdier, APRN

• Clinical Medical Laboratory in Storrs, CT
• Providers in Storrs, CT by specialty
• Clinical Medical Laboratory in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.