Individual provider Active NPI

Nancy M Grant, PNP

  • Nurse Practitioner
  • New London, CT
National Provider Identifier
1023024965
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
000836 Issued in CT
Practice address
36 Waller St
School Based Health Center BDJM
New London, CT 06320
Phone
(860) 701-3772
Fax
(860) 701-3772
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X 000836 CT
Nurse Practitioner 363L00000X 000836 CT Primary

Addresses

Primary practice location

36 Waller St
School Based Health Center BDJM
New London, CT 06320

Mailing address

255 Hempstead St
New London, CT 06320-6204

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

LicenseStateTypeSpecialty
000836CTMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: nancy.grant@ctproviderdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1023024965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WALLER ST",
            "address_2": "SCHOOL BASED HEALTH CENTER BDJM",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-701-3772",
            "fax_number": "860-701-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NANCY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "CT",
            "license": "000836",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "000836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.