Individual provider Active NPI

Jill McEachern, APRN

  • Women's Health Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1053392837
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4630 Issued in CT
Practice address
705 Boston Post Rd
Unit 6C
Guilford, CT 06437-9994
Phone
(475) 308-8619
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4630 CT
Adult Health Nurse Practitioner 363LA2200X 004630 CT
Women's Health Nurse Practitioner 363LW0102X 4630 CT Primary
Gynecology Physician 207VG0400X RN00127171 WA
Gynecology Physician 207VG0400X AP30005373 WA

Addresses

Primary practice location

705 Boston Post Rd
Unit 6C
Guilford, CT 06437-9994

Mailing address

705 Boston Post Rd Ste C6
Guilford, CT 06437-2744
Phone (475) 308-8619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120426000499 CT Practitioner - Nurse Practitioner 4880658863 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30005373WAMDGynecology Physician
RN00127171WAMDGynecology Physician
004630CTMDOccupational Therapist
4630CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quinnipiac Medical of Branford, LLC CurrentSince Feb 20, 2023 Accepting new patients
Northwest Hospital & Medical Center Past Accepting new patients
Women'S Clinical Research Center, PS Gynecology PastSince Jan 1, 2018 Accepting new patients

Locations

960 Main St
Branford, CT 06405
Phone (203) 488-6358

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27673/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1053392837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BOSTON POST RD STE C6",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372744",
            "telephone_number": "475-308-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BOSTON POST RD",
            "address_2": "UNIT 6C",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064379994",
            "telephone_number": "475-308-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEACHERN",
        "first_name": "JILL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "4630",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "004630",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "4630",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "RN00127171",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "AP30005373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.