Deloretta Theresa Eckenrode, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3709 Issued in CT

Practice address

31 Cherry St Ste 1
Milford, CT 06460-3465

Phone

(203) 874-7001

NPI assigned

May 8, 2006

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Deloretta Theresa Lawrence Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Connecticut Go Green Medical PLLC

  • Nurse Practitioner
  • Milford, CT
  • NPI 1881462232
  Medicare reassignment NPD Authorized official
• NP Care, LLC

  • Internal Medicine Physician
  • Shelton, CT
  • NPI 1326238866
  NPD (past)
• NP Care, LLC

  • Nurse Practitioner
  • Shelton, CT
  • NPI 1386693182
  NPD (past)
• Pain & Spine Specialists of Connecticut, LLC

  • Specialist
  • New Milford, CT
  • NPI 1174826598
  NPD (past)
• Brooklyn Anesthesia Medical Group, PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1679524813
  NPD (past)
• University Physicians of Brooklyn, Inc

  dba Downstate Health Physicians

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1104878180
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1083663058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CHERRY ST STE 1",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603465",
            "telephone_number": "203-874-7001",
            "fax_number": "203-874-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 CHERRY ST STE 1",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603465",
            "telephone_number": "203-874-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKENRODE",
        "first_name": "DELORETTA",
        "middle_name": "THERESA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332927",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "3709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008001644",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELORETTA",
            "last_name": "LAWRENCE",
            "middle_name": "THERESA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Eliana Echeverry, M.A. CCC-SLP
• Yolani P Edirisinghe, DMD
• Luke Joseph Edmondson
• Richard Kevin Edwards, APRN
• Elizabeth Domack LLC
• Melissa Emmanuel, LPC

• Family Nurse Practitioner in Milford, CT
• Providers in Milford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.

Verify at the official NPI Registry.