U. S. COAST GUARD ACADEMY (NPI# 1013001957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013001957 |
| Entity Type | Organization |
| Organization Name | U. S. COAST GUARD ACADEMY |
| Practice Address |
15 Mohegan Ave New London CT 06320-8100 |
| Practice Telephone | 8604448402 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RAY A CHANEY (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 8607016736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | UNITED STATES COAST GUARD ACADEMY PARENTS ASSOCIATION, INC. | 35 Elizabeth St, Knight Hall K202, Hartford, CT 06105 |
| Connecticut Business Registrations | United States Coast Guard Academy Sponsored Programs and Research, Inc | 35 Elizabeth St, Knight Hall K202, Hartford, CT 06105 |
| System for Award Management (SAM) Entities | UNITED STATES COAST GUARD ACADEMY SPONSORED PROGRAMS AND RESEARCH, INC | 47 Mohegan Ave, New London, CT 06320-8111 |
| Street Address |
15 MOHEGAN AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-8100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114913316 | Christopher Bellizzi | Massage Therapist | 15 Mohegan Ave, New London, CT 06320-8100 | 2005-09-22 |
| 1689204919 | Colleen Mccue | Physician Assistant | 15 Mohegan Ave, New London, CT 06320-8100 | 2020-01-26 |
| 1184146029 | Elizabeth A Fitch | Registered Nurse | 15 Mohegan Ave, Michel Hall, New London, CT 06320 | 2017-07-12 |
| 1295181709 | Katrina Rochester | Registered Nurse | 15 Mohegan Ave, New London, CT 06320-8100 | 2016-05-13 |
| 1568863843 | Micah Gentile | Physician Assistant | 15 Mohegan Ave, New London, CT 06320-8100 | 2014-09-05 |
| 1174960223 | Karen Louise Robertson | Dental Hygienist | 15 Mohegan Ave, New London, CT 06320-8100 | 2013-05-30 |
| 1124274816 | Eugene Francis Pereira | Spec/Tech, Pathology | 15 Mohegan Ave, Uscga Medical, New London, CT 06320-4195 | 2008-08-13 |
| 1912161969 | Mark S Jadofsky | Technician, Other | 15 Mohegan Ave, U.S. Caost Guard Academy, New London, CT 06320-0052 | 2008-07-17 |
| 1275700403 | Mary Lathrop | Specialist/Technologist | 15 Mohegan Ave, Michel Hall, New London, CT 06320-8100 | 2008-05-16 |
| 1366619512 | Reina Carolina Garcia | Dental Assistant | 15 Mohegan Ave, Uscgacademy (m), New London, CT 06320-8100 | 2008-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346389319 | Katy L. Reynolds | Clinic/Center | 15 Mohegan Avenue, United States Coast Guard Academy, New London, CT 06320-4195 | 2007-02-06 |
| 1760673032 | U.S. Coast Guard | Clinic/Center | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972564243 | Branch Medical Clinic Groton | Clinic/Center | 1 Wahoo Ave, Box 600, Code 42g, Groton, CT 06340-2324 | 2006-03-28 |
| City | NEW LONDON |
| Zip Code | 06320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.