CRESCENT ST OBGYN LLC (NPI# 1184884355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184884355 |
| Entity Type | Organization |
| Organization Name | CRESCENT ST OBGYN LLC |
| Practice Address |
49 Crescent St Middletown CT 06457-3601 |
| Practice Telephone | 8603449993 |
| Mailing Telephone | 8603449993 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |
| Authorized Official Name | DR. JULIE S FLAGG (OWNER) |
| Authorized Official Telephone | 8603449993 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 002684 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004236924 | 05 |
| Street Address |
49 CRESCENT ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669424248 | Carla Mcleod | Obstetrics & Gynecology | 49 Crescent St, Middletown, CT 06457-3601 | 2006-05-16 |
| 1750436119 | Laura Bony | Obstetrics & Gynecology | 49 Crescent St, Middletown, CT 06457-3601 | 2007-01-24 |
| 1265487094 | Crescent Street Obstetrics and Gynecology LLC | Advanced Practice Midwife | 49 Crescent St, Middletown, CT 06457 | 2006-05-23 |
| 1164476925 | Susan Davey | Advanced Practice Midwife | 49 Crescent St, Middletown, CT 06457-3601 | 2006-05-19 |
| 1760435879 | Julie S Flagg IIi | Obstetrics & Gynecology | 49 Crescent St, Middletown, CT 06457-3601 | 2006-05-18 |
| 1578516688 | Anne S Bingham | Obstetrics & Gynecology | 49 Crescent St, Middletown, CT 06457-3601 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548822000 | Janice Blake | Nurse Practitioner | 400 Saybrook Rd Ste 214, Middletown, CT 06457-4773 | 2019-07-05 |
| 1740637388 | Glenda Gagante | Nurse Practitioner | 103 Beacon St, Middletown, RI 02842-4805 | 2016-05-23 |
| 1538584255 | Olympia Rian Perna | Nurse Practitioner | 1000 Route 35, Suite 200, Middletown, NJ 07748-2606 | 2014-03-04 |
| 1568682581 | Valli Cohen | Nurse Practitioner | 325 High St, Middletown, CT 06459-3232 | 2007-05-01 |
| 1265550842 | Barbara Dedman | Nurse Practitioner | Davison Health Center 327 High St, Middletown, CT 06459-0001 | 2007-03-26 |
| 1366547358 | Susan M Bordonaro | Nurse Practitioner | 102 Valley Rd, Middletown, RI 02842-5237 | 2006-09-14 |
| 1932133881 | Karla Kay Telfer | Nurse Practitioner | 602 N 5th St, Middletown, IN 47356-1008 | 2006-07-10 |
| 1487648812 | Barbara Manco | Nurse Practitioner | Rcwatc, 117 Seward Ave, Suite 12-16, Middletown, NY 10940 | 2005-08-31 |
| 1164428793 | Paula May Rutledge | Nurse Practitioner | 306 E Main St, Middletown, DE 19709-1482 | 2005-06-28 |
| 1336758747 | Kate Elizabeth Garvin | Nurse Practitioner | 1025 W Harrisburg Pike, Middletown, PA 17057-4848 | 2020-07-31 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.