Active NPI
Deborah L Collins-Perrica
- Nurse Practitioner
- Avon, CT
National Provider Identifier
1013140540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 004075
- Practice address
- 21 Waterville Rd
Avon, CT 06001-2097 - Phone
- (860) 284-0182
- Fax
- (860) 284-6804
- NPI assigned
- Sep 1, 2009
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 004075 | CT | Primary |
Addresses
Primary practice location
21 Waterville Rd
Avon, CT 06001-2097
Mailing address
21 Waterville Road
Avon, CT 06001-2097
Phone (860) 284-0182
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004075 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251763200000",
"number": "1013140540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WATERVILLE ROAD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-284-0182",
"fax_number": "860-284-6804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-284-0182",
"fax_number": "860-284-6804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS-PERRICA",
"first_name": "DEBORAH",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-01",
"last_updated": "2009-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "004075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.