Kimberly J Lane, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

000708 Issued in CT

Practice address

320 Pomfret St
Putnam, CT 06260-1836

Phone

(860) 928-6541

Fax

(860) 963-6393

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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 and National Provider Directory roles.

• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  NPD
• Natchaug Hospital, Inc.

  • Psychiatric Hospital
  • Mansfield Center, CT
  • NPI 1295811321
  NPD (past)
• Psych Associates New England

  • Psychologist
  • Putnam, CT
  • NPI 1952356537
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1093765232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Kennedy Dr",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062601939",
            "country_code": "US",
            "telephone_number": "860-928-7704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Hartford Pike",
            "address_purpose": "LOCATION",
            "city": "Dayville",
            "state": "CT",
            "postal_code": "062412159",
            "country_code": "US",
            "telephone_number": "860-779-0867",
            "fax_number": "860-779-0382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "168 Route 171",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "CT",
            "postal_code": "062813123",
            "country_code": "US",
            "telephone_number": "860-928-7775",
            "fax_number": "860-928-3852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Lathrop Rd",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "CT",
            "postal_code": "063742061",
            "country_code": "US",
            "telephone_number": "860-457-9191",
            "fax_number": "860-457-9192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Green Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "Danielson",
            "state": "CT",
            "postal_code": "062393509",
            "country_code": "US",
            "telephone_number": "860-774-1255",
            "fax_number": "860-779-2059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "000708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4007084",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "000708",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Lahaie, APRN
• Sydney E Lakowsky
• Stacy L Lambert
• Jenna Maegan Lamothe
• Adam Lane, LMSW
• Stephanie A Langley
• Cynthia Lassiter, LCSW
• Kelli Lavoie, P.T.A.
• Melissa Tawny Lawrence
• Amy Beth Lawton, PHARM. D.

• Psychiatric/Mental Health Nurse Practitioner in Putnam, CT
• Providers in Putnam, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.