Christina Fultz Rickenback, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

000028 Issued in CT

Practice address

One Wildwood Medical Center
Essex, CT 06426

Phone

(860) 767-0168

Fax

(860) 767-1803

NPI assigned

Jul 29, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Wildwood Pediatrics and Adolescent Medicine LLC

  • Pediatrics Physician
  • Essex, CT
  • NPI 1750405023
  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1104831460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE WILDWOOD MEDICAL CENTER",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-767-0168",
            "fax_number": "860-767-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WILDWOOD MEDICAL CENTER",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-767-0168",
            "fax_number": "860-767-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKENBACK",
        "first_name": "CHRISTINA",
        "middle_name": "FULTZ",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "000028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marybeth Pytlik Ellison, MD
• Theresa M Ramponi, APRN
• Raymond Oakes, MSW, LLC
• Laura Jean Reynolds, M.S.,P.T.
• Keith Richter, LCSW
• Rite Aid
• Rodney Hornbake MD, PC
• Dana J Rotella, DDS
• Ewa T Ruggieri, M.D.
• Mary Ellen Ruggiero, RN HCSW

• Pediatric Nurse Practitioner in Essex, CT
• Providers in Essex, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.