GENESIS ELDERCARE PHYSICIAN SERVICES LLC (NPI# 1164415196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164415196 |
Entity Type | Organization |
Organization Name | GENESIS ELDERCARE PHYSICIAN SERVICES LLC |
Practice Address |
1 Emerson Dr Kimberly Hall North Windsor CT 06095 |
Mailing Address |
Po Box 62946 Baltimore MD 21264-2946 |
Practice Telephone | 8606886443 |
Practice Fax Number | 8606885230 |
Mailing Telephone | 4104947607 |
Mailing Fax Number | 6109257387 |
Enumeration Date | 2005-08-24 |
Last Update Date | 2019-08-05 |
Authorized Official Name | ERIC SHAPIRO (VP, AREA CONTROLLER) |
Authorized Official Telephone | 4108327790 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
CT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 004126919 | 05 | |
CT | 004195021 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801215041 | Genesis Eldercare Physician Services LLC | Family Medicine | 835 Tenderfoot Hill Rd # T, Colorado Springs, CO 80906 | 2014-04-15 |
1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
1609180926 | Genesis Eldercare Physician Services LLC | Family Medicine | 6508 Deer Pointe Dr Ste A, Salisbury, MD 21804 | 2010-07-28 |
1326148107 | Genesis Eldercare Physician Services LLC | Skilled Nursing Facility | 14233 Alta Oaks Dr, Rockville, MD 20850-7413 | 2006-09-22 |
1699710202 | Genesis Eldercare Physician Services LLC | Internal Medicine | 11 Dairy Ln, Fredericksburg, VA 22405-2663 | 2006-06-18 |
1881635183 | Genesis Eldercare Physician Services LLC | Internal Medicine | 6508 Deer Pointe Dr, Suite A, Salisbury, MD 21804 | 2006-06-09 |
1104819259 | Genesis Eldercare Physician Services LLC | Internal Medicine | 464 Main St, Heritage Hall East, Agawam, MA 01001 | 2005-08-24 |
1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
1548615313 | Genesis Eldercare Physician Services LLC | Internal Medicine | 7900 Constitution Ave Ne, Albuquerque, NM 87110 | 2016-04-29 |
1659737898 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-01-04 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | GENESIS ELDERCARE PHYSICIAN SERVICES LLC | 101 E State St, Kennett Sq, PA 19348-3109 |
Street Address |
1 EMERSON DR KIMBERLY HALL NORTH |
City | WINDSOR |
State | CT |
Zip Code | 06095 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598377251 | Amanda Archambault | Speech-Language Pathologist | 1 Emerson Dr, Windsor, CT 06095-3204 | 2020-08-23 |
1285259481 | Jenna Ann Borrmann | Physical Therapy Assistant | 1 Emerson Dr, Windsor, CT 06095-3200 | 2020-06-12 |
1295378586 | Kristen Marie Shaw | Physical Therapist | 1 Emerson Dr, Windsor, CT 06095-3204 | 2019-10-20 |
1669946588 | Olusegun Olaosebikan | Nurse Practitioner | 1 Emerson Dr, Windsor, CT 06095-3204 | 2019-01-14 |
1336631183 | Andrew Gray | Physical Therapy Assistant | 1 Emerson Dr, Windsor, CT 06095-3204 | 2018-06-06 |
1447764097 | Ishani Ravi Patel | Physical Therapist | 1 Emerson Dr, Windsor, CT 06095-3204 | 2017-11-18 |
1790295772 | Melissa Lynn Bourgeois | Physical Therapist | 1 Emerson Dr, Windsor, CT 06095-3204 | 2017-10-04 |
1275050791 | Amy Mccracken | Speech-Language Pathologist | 1 Emerson Dr, Windsor, CT 06095-3204 | 2017-08-25 |
1285157339 | Tara Gehring | Physical Therapy Assistant | 1 Emerson Dr, Windsor, CT 06095-3204 | 2017-07-20 |
1679005656 | Luisell M Velazquez | Occupational Therapy Assistant | 1 Emerson Dr, Windsor, CT 06095-3204 | 2017-03-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285255992 | Dnd Group of Companies LLC | Psychologist | 204 Old Village Cir, Windsor, CT 06095 | 2020-05-04 |
1811467442 | Joseph C Gaetani Jr. | Specialist | 340 Broad Street Suite 320, Windsor, CT 06095 | 2018-11-27 |
1447629043 | Brittany Higginbotham | Marriage & Family Therapist | 347 Park Avenue, Windsor, CT 06095 | 2015-09-24 |
1457737454 | Eric Han | Dentist | 697 Poquonock Ave, Windsor, CT 06095 | 2015-08-03 |
1265780894 | Annetta Ruth Troche | Nurse Practitioner | 22 Parkwood Drive, Windsor, CT 06095 | 2012-08-29 |
1821234006 | Milna Rosario | Social Worker | 6 Poquonock Avenue, Windsor, CT 06095 | 2008-12-18 |
1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
1972708758 | Price Chopper Inc | Pharmacy | 675 Poquoncock Ave, Windsor, CT 06095 | 2007-06-20 |
1396870358 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 1080 Day Hill Road, Windsor, CT 06095 | 2007-02-22 |
1841342094 | Thomas F. Reif | Psychologist | 32 Maple Avenue, Windsor, CT 06095 | 2007-01-17 |
Find all providers in zip 06095 |
Taxonomy Code | 207RG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Geriatric Medicine |
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427612100 | Holistic Healing Partners, LLC | Internal Medicine | 290 Baxter Ln, Milford, CT 06460-6813 | 2019-04-28 |
1003113762 | Jennifer Anne Freimund | Internal Medicine | 1450 Chapel St Ste 107, New Haven, CT 06511-4405 | 2011-02-16 |
1720211444 | Joseph Daniel Demayo | Internal Medicine | 66 Skyline Dr, Middlebury, CT 06762-1717 | 2009-08-27 |
1679701882 | Southern Connecticut Geriatric & Preventive Medicine LLC | Internal Medicine | 4 Sagamore Cove Rd, Branford, CT 06405-5020 | 2009-06-25 |
1184896151 | Geriatric Medicine Consultants Home Visit Practice, LLC | Internal Medicine | 33 Birch Rd, West Hartford, CT 06119-1009 | 2008-03-30 |
1083814339 | Lefkowitz & Scollan, M.d.'s,llc | Internal Medicine | 469 E Main St, Meriden, CT 06450-6027 | 2007-07-24 |
1326116948 | Barney Spivack | Internal Medicine | 101 Long Lots Rd, Westport, CT 06880-3919 | 2006-12-01 |
1447267026 | Casey Ott | Internal Medicine | 22 Old Waterbury Rd # 103, Southbury, CT 06488-3848 | 2006-08-03 |
1447264155 | Audrey Lefkowitz | Internal Medicine | 469 E Main Street, Meriden, CT 06450 | 2006-07-28 |
1477583540 | Geraldine M Fabregas | Internal Medicine | 280 Alden Ave, New Haven, CT 06515-2114 | 2006-07-04 |
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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.