Active NPI
Jill McEachern, APRN
- Women's Health Nurse Practitioner
- Guilford, CT
National Provider Identifier
1053392837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 4630
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30005373 | WA | MD | Gynecology Physician |
| RN00127171 | WA | MD | Gynecology Physician |
| 004630 | CT | MD | Occupational Therapist |
| 4630 | CT | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quinnipiac Medical of Branford, LLC | Current | Accepting new patients | |
| Northwest Hospital & Medical Center | Past | Accepting new patients | |
| Women'S Clinical Research Center, PS | Gynecology | Past | Accepting new patients |
Locations
960 Main St
Branford, CT 06405
Phone (203) 488-6358
Interoperability endpoints
- 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.
-
- Internal Medicine Physician
- Branford, CT
- NPI 1982668240
-
- Health Service Clinic/Center
- Hamden, CT
- NPI 1952431066
-
- Obstetrics & Gynecology Physician
- Seattle, WA
- NPI 1730355199
-
- Gynecology Physician
- Seattle, WA
- NPI 1801914114
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.