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).
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 |
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 |
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 Name | Type Code |
---|---|
Climb Innovations LLC | Former Legal Business Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Connecticut Business Registrations | Climb Medical Group LLC | 51 Stonefield Trail, South Windsor, CT 06074 |
Street Address |
828 SULLIVAN AVE STE A |
City | SOUTH WINDSOR |
State | CT |
Zip Code | 06074 |
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 Code | 207QA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Addiction Medicine |
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. |
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 |
City | SOUTH WINDSOR |
Zip Code | 06074 |
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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.