4 Elements Direct Primary Care LLC
Internal Medicine in South Windsor, Connecticut
1730756636- Practice location
- 1300 Sullivan Ave, South Windsor, CT 06074-2713
- Phone
- 860-469-5646
- Fax
- 860-310-1122
- Last updated
- November 1, 2025
4 Elements Direct Primary Care LLC is a healthcare organization based in South Windsor, CT. 4 Elements Direct Primary Care LLC practices in South Windsor, CT. The NPI Number for 4 Elements Direct Primary Care LLC is 1730756636. The current practice location address for 4 Elements Direct Primary Care LLC is 1300 Sullivan Ave, South Windsor, CT 06074-2713 and can be reached out via phone at 860-469-5646 and via fax at 860-310-1122.
Provider Profile Details
- NPI Number
- 1730756636
- Provider Name
- 4 Elements Direct Primary Care LLC
- Provider Entity Type
- Organization
- Address
- 1300 Sullivan Ave, South Windsor, CT 06074-2713
- Phone Number
- 860-469-5646
- Fax Number
- 860-310-1122
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Vasanth Kainkaryam, MD · Managing Member · 860-469-5656
- Provider Enumeration Date
- June 8, 2021
- Last Update Date
- November 1, 2025
- Certification Date
- November 1, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1300 Sullivan Ave
South Windsor, CT 06074-2713 - City
- South Windsor
- State
- Connecticut
- Zip
- 06074-2713
- Phone Number
- 860-469-5646
- Fax Number
- 860-310-1122
Provider Business Mailing Address Details
- Address
- 1300 Sullivan Ave
South Windsor, CT 06074-2713 - City
- South Windsor
- State
- CT
- Zip
- 06074-2713
- Phone Number
- 860-469-5646
- Fax Number
- 860-310-1122
License Information
- Taxonomy (1)
- Preventive Medicine, Obesity Medicine · 2083B0002X
- Taxonomy (2)
- Pediatrics · 208000000X
- Taxonomy (3)
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of 4 Elements Direct Primary Care LLC?
The NPI number of 4 Elements Direct Primary Care LLC is 1730756636. It was assigned on June 8, 2021 and is currently active in the NPPES registry.
What is the specialty of 4 Elements Direct Primary Care LLC?
4 Elements Direct Primary Care LLC is registered under the primary taxonomy Internal Medicine (code 207R00000X).
Where does 4 Elements Direct Primary Care LLC practice?
The practice location is 1300 Sullivan Ave, South Windsor, CT 06074-2713. The office can be reached at 860-469-5646 (phone) or 860-310-1122 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1730756636 directly on the NPPES registry website.