NPIMap

Organization Active NPI

Advanced Care Associates, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
National Provider Identifier
1992845481
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ADVANCED CARE ASSOCIATES, LLC
Practice address
20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214
Phone
(800) 370-3651
Fax
(860) 510-0020
NPI assigned
Feb 7, 2007
Last updated
Mar 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
Brenda De Gray
Title
Credentialing Coordinator
Phone
(800) 370-3651

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214

Mailing address

20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214
Phone (800) 370-3651

National Provider Directory

National Provider Directory

Locations

20 Research Pkwy
#3
Old Saybrook, CT 06475

Practitioners & affiliated clinicians

Practitioners 9

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1992845481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "address_2": "SUITE C",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651",
            "fax_number": "860-510-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "address_2": "SUITE C",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651",
            "fax_number": "860-510-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "DE GRAY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "800-370-3651"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.