Active NPI
Nancy M Grant, PNP
- Nurse Practitioner
- New London, CT
National Provider Identifier
1023024965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 000836
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 000836 | CT | MD | Nurse Practitioner |
Interoperability endpoints
- 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.