Vanguard Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VANGUARD MEDICAL LLC

Practice address

1 Parrott Dr Ste 400
Shelton, CT 06484-4853

Phone

(860) 808-6532

NPI assigned

Oct 10, 2018

Organization subpart

No

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

Authorized official

Name

Ivan Nussberg

Title

Owner

Phone

(860) 808-6532

Specialties & licenses 1

Addresses

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clancy James Purcell

  • Orthotic Fitter
  • Shelton, CT
  • NPI 1396210308
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1992270599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SODOM LN STE 1",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182608",
            "telephone_number": "860-808-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARROTT DR STE 400",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844853",
            "telephone_number": "860-808-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "NUSSBERG",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-808-6532"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Value Based Long Term Care K PC
• Value Based Long Term Care LLC
• David Matthew Van Ess, M.D.
• Kimberly Anne Van Hoose, OTR/L
• Scott Alan Vander Vennet, MD
• Marissa Vecca
• John-Paul Velasco, M.D.
• Noel Velasco, MD
• Camille Velez, PT, DPT
• Erika Velez

• All providers in Shelton, CT
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.