Active NPI
Charisse McCotter
- Phlebotomy Technician
- New Haven, CT
National Provider Identifier
1003672825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- 20-0106Y21
- Practice address
- 191 Delauro Dr Apt M
New Haven, CT 06511-6013 - Phone
- (203) 928-9155
- NPI assigned
- Feb 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | 20-0106Y21 | CT | Primary |
Addresses
Primary practice location
191 Delauro Dr Apt M
New Haven, CT 06511-6013
Mailing address
1204 Main St # 829
Branford, CT 06405-3787
Phone (203) 928-9155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-0106Y21 | CT | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1003672825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 MAIN ST # 829",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064053787",
"telephone_number": "203-928-9155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 DELAURO DR APT M",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065116013",
"telephone_number": "203-928-9155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOTTER",
"first_name": "CHARISSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-28",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CT",
"license": "20-0106Y21",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.