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MHS PRIMARY CARE NPI 1104043017


NPI Information

NPI: 1104043017
Provider Name: MHS PRIMARY CARE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 07D0879309

Address:
154 MAIN ST
OLD SAYBROOK, CT
ZIP 06475
Phone: (860) 395-1212
Get Directions

MHS PRIMARY CARE is a family medicine in Old Saybrook, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MHS PRIMARY CARE NPI is 1104043017. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

154 MAIN ST
OLD SAYBROOK, CT
ZIP 06475-373
Phone: (860) 395-1212
Fax: (860) 358-8654

The provider's authorized official is Susan Serkey .
The authorized official title is Practice Administrator and has the following contact phone number (860) 358-4802.

The CLIA number assigned to this NPI record is 07D0879309 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/20/2007 and was last updated on 1/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineCONNECTICUTNo
3363A00000XPhysician AssistantNo
4363LF0000XNurse PractitionerFamilyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C02139MEDICARE PINCONNECTICUT
204173259MEDICAIDCONNECTICUT
3C02187MEDICARE PINCONNECTICUT
4C02326MEDICARE PINCONNECTICUT
5C02243MEDICARE PINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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