Individual provider Active NPI

Ann Elisa Wratchford, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Groton, CT
National Provider Identifier
1063598316
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
003947 Issued in CT
Practice address
1057 Poquonnock Rd
Suite 1
Groton, CT 06340-6630
Phone
(860) 326-5597
Fax
(860) 326-5362
NPI assigned
Oct 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R55783 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003947 CT Primary

Addresses

Primary practice location

1057 Poquonnock Rd
Suite 1
Groton, CT 06340-6630

Mailing address

51 Starwood TRL
Colchester, CT 06415-1868
Phone (860) 319-1444

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

State licenses

LicenseStateTypeSpecialty
3947CTMDClinical Psychologist
R55783CTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1063598316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 STARWOOD TRL",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151868",
            "telephone_number": "860-319-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 POQUONNOCK RD",
            "address_2": "SUITE 1",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406630",
            "telephone_number": "860-326-5597",
            "fax_number": "860-326-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRATCHFORD",
        "first_name": "ANN",
        "middle_name": "ELISA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "R55783",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.