PRIME HEALTHCARE, PC (NPI# 1184819302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184819302 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE, PC |
| Practice Address |
30 Jordan Ln Wethersfield CT 06109-1278 |
| Practice Telephone | 8602630253 |
| Practice Fax Number | 8602630262 |
| Mailing Telephone | 8602630253 |
| Mailing Fax Number | 8602630262 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2015-08-03 |
| Authorized Official Name | SUSAN ALBANO (CEO) |
| Authorized Official Telephone | 8602630253 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208000000X | Pediatrics | 54316 | CT | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004201480 | 05 | |
| CT | 004185147 | 05 | |
| CT | 008058707 | 05 |
| Street Address |
30 JORDAN LN |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109-1278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730166422 | Wayne Christopher Paulekas | Internal Medicine | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2005-12-23 |
| 1669972444 | Brian Gomes | Nurse Practitioner | 30 Jordan Ln, Wethersfield, CT 06109 | 2018-02-18 |
| 1588977540 | Right At Home In Homecare & Assistance | Home Health | 30 Jordan Ln, 3rd Floor, Wethersfield, CT 06109-1278 | 2010-07-20 |
| 1558531996 | Deborah Ann Broadley | Nurse Practitioner | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2008-02-29 |
| 1184832354 | Prime Healthcare (sleep Lab) | Clinic/Center | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2007-05-19 |
| 1508089244 | Amarillys Rodriguez | Family Medicine | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2007-04-11 |
| 1659344174 | Katherine Thomsen | Nurse Practitioner | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2006-02-08 |
| 1073584801 | Robert Reginio | Internal Medicine | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2006-01-30 |
| 1912984618 | Frederick Pope | Internal Medicine | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2005-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223293 | Sonya Voytas Maher | Technician/Technologist | 1197 Main Street, Coventry, CT 06109 | 2020-04-16 |
| 1336775485 | Lance Morton | Hearing Instrument Specialist | Miracle Ear, 1206 Silas Deane Hwy, Wethersfield, CT 06109 | 2020-03-20 |
| 1780178350 | Bethany Wittman | Audiologist | 988 Silas Deane Highway, Wethersfield, CT 06109 | 2018-06-18 |
| 1659806404 | Lauren M Mcgrath | Physical Therapist | 672 Silas Deane Highway, Wethersfield, CT 06109 | 2017-04-28 |
| 1851824858 | A Plus Senior Home Care LLC | In Home Supportive Care | 183 Clearfield Rd, Wethersfield, CT 06109 | 2017-04-06 |
| 1801270707 | Dr.matthew Carbone Family Chiropractic | Chiropractor | 15 Country Club Rd, Wethersfield, CT 06109 | 2015-07-10 |
| 1629455910 | Melanie Anne Parker | Physical Therapist | 850 Silas Deane Hwy #2, Wethersfield, CT 06109 | 2015-05-06 |
| 1508271875 | Integrated Procare Services | Counselor | 415 Silas Deane Hwy # 401, Wethersfield, CT 06109 | 2014-06-25 |
| 1265867394 | Caregiver Homes of Connecticut, Inc | Custodial Care Facility | 912 Silas Dean Highway - Suite 101, Weathersfield, CT 06109 | 2013-09-09 |
| 1285925651 | Steven Warren Young | Pharmacist | 657 Silas Deane Highway, Rite Aid Pharmacy, Wethersfield, CT 06109 | 2011-04-20 |
| Find all providers in zip 06109 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1518379759 | Grant Richard Golub | Internal Medicine | 25 Knight St, Wethersfield, CT 06109-2834 | 2014-05-22 |
| 1053593079 | Tamika Blackburn | Internal Medicine | 1260 Silas Deane Hwy Ste 103, Wethersfield, CT 06109-4363 | 2007-11-30 |
| 1053402263 | Thomas Andrew Brown | Internal Medicine | 672 Silas Deane Hwy, Kathy's Urgent Care of Wethersfield, Wethersfield, CT 06109-3053 | 2006-09-27 |
| 1548209455 | Josephine Contrino | Internal Medicine | 78 Beaver Rd, Suite 1a, Wethersfield, CT 06109-2295 | 2006-06-06 |
| 1730166422 | Wayne Christopher Paulekas | Internal Medicine | 30 Jordan Ln, Wethersfield, CT 06109-1278 | 2005-12-23 |
| 1265039408 | Askari H. Jafri, M.d., LLC | Internal Medicine | 239 Silas Deane Hwy, Fl 2, Wethersfield, CT 06109-1730 | 2020-10-01 |
| 1821381385 | Abigail L Chua | Internal Medicine | 1260 Silas Deane Hwy, Wethersfield, CT 06109-4362 | 2011-05-17 |
| 1801085618 | Scott John Walker | Internal Medicine | 1260 Silas Deane Hwy, Wethersfield, CT 06109-4362 | 2007-10-17 |
| 1891890216 | Anne Pinou | Internal Medicine | 1260 Silas Deane Hwy, Wethersfield, CT 06109-4362 | 2006-09-13 |
| 1821193343 | Thomas Savinelli | Internal Medicine | 1260 Silas Deane Hwy, Wethersfield, CT 06109-4362 | 2006-09-13 |
| Find all providers in WETHERSFIELD | ||||
| City | WETHERSFIELD |
| Zip Code | 06109 |
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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.