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BACK TO HEALTH OF BRANFORD, LLC
NPI 1215958772
Internal Medicine in Branford, CT

Active since July 21, 2006CLIA 07D1072612 · Waiver
400 WEST MAIN STREET, BRANFORD, CT 06405(203) 483-7778(203) 481-0234 Get Directions Write a Review

NPPES record last updated: December 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Back To Health Of Branford, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BACK TO HEALTH OF BRANFORD, LLC (NPI 1215958772) is a healthcare organization registered as an internal medicine in Branford, Connecticut and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 20, 2027 and lists Sharon L Bailey, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1215958772
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBACK TO HEALTH OF BRANFORD, LLC
Location Address400 WEST MAIN STREETBranford, CT 06405
Mailing Address400 W Main StBranford, CT 06405-3416 · (203) 483-7778 · Fax (203) 481-0234
Phone(203) 483-7778
Fax(203) 481-0234
Organization SubpartNo
Authorized OfficialSharon L BaileyOffice Administrator · (203) 483-7778
Enumeration DateJuly 21, 2006
Last NPPES UpdateDecember 22, 2014
✔ NPI 1215958772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CT · 037255
Definition
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.
Also ListedChiropractorTaxonomy 111N00000X · License 148 (CT), 001614 (CT)
Also ListedChiropractor · InternistTaxonomy 111NI0900X · License 000561 (CT)
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 037255 (CT)
Also ListedProsthetic/Orthotic SupplierTaxonomy 335E00000X · License 037255 (CT)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 002765 (CT)
400 WEST MAIN STREET, Branford, CT 06405
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Other Identifiers 11

OtherC02868Group
Medicaid008038901CT
Medicare PIN250000377
Medicare UPING93443
Medicare UPINS72173
Medicare NSC6696760001CT
Medicare UPING93443CT
Other07D1072612CT · Clia Waiver
Medicare UPINU18188
Medicaid008038939CT
Medicare PIN350001195

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D1072612

Back To Health Of Branford LLC · Branford, CT
Active · expires Aug 20, 2027
CLIA Number07D1072612
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateAugust 20, 2027
Laboratory DirectorMichael S. Wong MD
Laboratory Phone(203) 483-7778
Laboratory LocationBack To Health Of Branford LLC400 West Main Street, Branford, CT 06405
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREA BENKO D.C.
Chiropractor
400 WEST MAIN STREET
BRANFORD, CT 06405
South Central Connecticut Planning Region (203) 483-7778

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Back To Health Of Branford, LLC's NPI number?

The NPI number for Back To Health Of Branford, LLC is 1215958772. It was assigned to this organization in the NPPES registry on July 21, 2006.

Where is Back To Health Of Branford, LLC located?

Back To Health Of Branford, LLC is located at 400 West Main Street, Branford, CT 06405. The listed phone number is (203) 483-7778.

What is Back To Health Of Branford, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Back To Health Of Branford, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D1072612) is associated with this NPI, valid through August 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Back To Health Of Branford, LLC was last updated on December 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.