Individual provider Active NPI

Jessica Banning

  • Family Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1083383731
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9969 Issued in CT
Practice address
1 Lathrop Ave
Norwich, CT 06360-2308
Phone
(860) 204-0883
NPI assigned
Sep 7, 2021
Last updated
May 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9969 CT Primary

Addresses

Primary practice location

1 Lathrop Ave
Norwich, CT 06360-2308

Mailing address

2 Lathrop Ave
Norwich, CT 06360-2340
Phone (860) 608-3042

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
I20211104002649 CT Practitioner - Nurse Practitioner 3678962073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

100 Perkins Farm Dr
Suite 301
Mystic, CT 06355-4041
Phone (860) 572-5400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jan 15, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jan 15, 2024 Accepting new patients
Healthcall Primary Care Center PC CurrentSince Nov 1, 2021 Accepting new patients
Hartford Hospital Past Accepting new patients

Locations

100 Perkins Farm Dr
Mystic, CT 06355
Phone (860) 572-5455

100 Perkins Farm Dr
Ste 301
Mystic, CT 06355
Phone (860) 572-5400

2 Lathrop Ave
Norwich, CT 06360
Phone (860) 204-0332

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: jbanning349773@xdr.hhchealthdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1083383731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LATHROP AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602340",
            "telephone_number": "860-608-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LATHROP AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602308",
            "telephone_number": "860-204-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNING",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.