Kathleen M Pacheco, RN, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

R53439 Issued in CT

Practice address

365 Montauk Ave
New London, CT 06320-4700

Phone

(860) 444-4737

Fax

(860) 444-4775

NPI assigned

Jun 10, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Specialists of Southeastern Connecticut, Inc.

  • Internal Medicine Physician
  • New London, CT
  • NPI 1588844591
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1003042623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-444-4737",
            "fax_number": "860-444-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-444-4737",
            "fax_number": "860-444-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CT",
            "license": "R53439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Barrett Oriente, MS, OTR/L
• Lisa Michelle Otto, LCSW
• Tunnesia Owens, LMSW
• Mariel Ozoria, BA
• Jasmine Pacheco
• Leeann Page
• Thomas David Page
• Izabella Palak, FNP
• Angeline Bossa Pamphile, APRN
• Neil Panchal, D.O

• Diabetes Educator Registered Nurse in New London, CT
• Providers in New London, CT by specialty
• Diabetes Educator Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.