CLIMB MEDICAL GROUP LLC


Address: 828 Sullivan Ave Ste A, South Windsor, CT 06074
Phone: 8603275140

CLIMB MEDICAL GROUP LLC (NPI# 1093203291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093203291
Entity Type Organization
Organization Name CLIMB MEDICAL GROUP LLC
Other Organization Name CLIMB INNOVATIONS LLC
Practice Address 828 Sullivan Ave Ste A
South Windsor
CT 06074
Mailing Address 1131 Tolland Tpke # 129-o
Manchester
CT 06042-1679
Practice Telephone 8603275140
Enumeration Date 2018-04-24
Last Update Date 2019-01-24
Authorized Official Name DR. CHAD MCDONALD (CEO OF CLIMB MEDICAL GROUP LLC)
Authorized Official Telephone 8606443118
Authorized Official Credential DO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
53445 CT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CT GROUP NPI FOR CLIMB MEDICAL GROUP LLC 1093203291 01
CT MY PERSONAL NPI NUMBER 1942592514 01
CT PRIOR NPI FOR PRIOR LEGAL NAME (CLIMB INNOVATIONS LLC) 1396193488 01

Other Provider/Organization Names

Other Name Type Code
Climb Innovations LLC Former Legal Business Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Connecticut Business Registrations Climb Medical Group LLC 51 Stonefield Trail, South Windsor, CT 06074

Office Location

Street Address 828 SULLIVAN AVE STE A
City SOUTH WINDSOR
State CT
Zip Code 06074

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174144919 Russo Therapeutics, LLC Occupational Therapist 561 King Street, South Windsor, CT 06074 2020-05-04
1144706631 Chana Judith Hoagland Nurse Practitioner 276 Quarry Brook Drive, South Windsor, CT 06074 2018-07-17
1528506516 William P Guinan, Md and Associates LLC Obstetrics & Gynecology 25 Oakland Road, South Windsor, CT 06074 2017-02-09
1487027678 Nadine Caron Nurse Practitioner 34 Pleasant Valley Rd, South Windsor, CT 06074 2015-11-10
1275957920 Ellen Carol Ronsivalli Dietitian, Registered 70 High Street, South Windsor, CT 06074 2014-02-14
1881036457 Chandra Yellinedi Pharmacist 55 Frazer Fir, South Windsor, CT 06074 2013-07-24
1144665969 Brian Thomas Moy Internal Medicine 2400 Tamarack Ave Ste 101, South Windsor, CT 06074 2013-05-07
1093072886 Lydia Lormand Obstetrics & Gynecology 2600 Tamarack Ave Ste 200, South Windsor, CT 06074 2012-04-18
1578847307 International Institute for Professional Development, LLC Social Worker 435 Buckland Hills Road, South Windsor, CT 06074 2011-09-28
1750697124 Muhammad Riaz Khan Internal Medicine 240 Brookfiel St., South Windsor, CT 06074 2010-08-24
Find all providers in zip 06074

Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1972127678 Sound Recovery, Inc Family Medicine 110 Pellegrino Rd, Stonington, CT 06378-2129 2020-05-29
1043427115 Lakshmi Basu Family Medicine 931 Bank St., New London, CT 06320-2702 2007-05-17
1083022230 Staywell Health Care Inc Family Medicine 402 E Main St, Waterbury, CT 06702-1701 2014-07-31
1710312368 Connecticut Addiction Medicine, LLC Family Medicine 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 2013-09-13
1275608879 Christina Kolade Family Medicine 3851 Main St, Bridgeport, CT 06606-2864 2006-11-21
1972686707 Virgil T Rona Family Medicine 500 Vine Street, Blue Hills Hosptial, Hartford, CT 06112 2006-10-23
1043239783 Thomas R Defanti Family Medicine 75 Swantown Hl, North Stonington, CT 06359-1022 2006-07-19
1720017056 Jay B Benson Family Medicine 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 2006-06-30
1215993993 Richard D Smith Family Medicine 320 Pomfret St, Putnam, CT 06260-1836 2006-04-22

Competitor

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City SOUTH WINDSOR
Zip Code 06074

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Dataset Information

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.

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