Active NPI
Julie Hetherington
- Nurse Practitioner
- Stamford, CT
National Provider Identifier
1093988057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 001029
- Practice address
- 805 Atlantic St
Stamford, CT 06902-6805 - Phone
- (203) 327-5111
- Fax
- (203) 332-0376
- NPI assigned
- Apr 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 001029 | CT | Primary |
| Family Nurse Practitioner | 363LF0000X | 241904 | MA |
Addresses
Primary practice location
805 Atlantic St
Stamford, CT 06902-6805
Mailing address
805 Atlantic St
Stamford, CT 06902-6805
Phone (203) 327-5111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001029 | CT | MD | Addiction (Substance Use Disorder) Counselor |
| 241904 | MA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1093988057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 ATLANTIC ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069026805",
"telephone_number": "203-327-5111",
"fax_number": "203-332-0376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 ATLANTIC ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069026805",
"telephone_number": "203-327-5111",
"fax_number": "203-332-0376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETHERINGTON",
"first_name": "JULIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "001029",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "241904",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.