Individual provider Active NPI

Kaitlin Heaney Concannon, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1073455978
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
17588 Issued in CT
Practice address
200 Retreat Ave
Hartford, CT 06106-3310
Phone
(860) 545-7909
NPI assigned
Apr 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17588 CT Primary

Addresses

Primary practice location

200 Retreat Ave
Hartford, CT 06106-3310

Mailing address

200 Retreat Ave
Hartford, CT 06106-3310
Phone (860) 545-7909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1073455978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063310",
            "telephone_number": "860-545-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063310",
            "telephone_number": "860-545-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "KAITLIN",
        "middle_name": "HEANEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "17588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.