Individual provider Active NPI

Joan Corradino, APRN

  • Adult Health Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1104849553
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
002269 Issued in CT
Practice address
1216 Farmington Ave
Room 102
West Hartford, CT 06107-2672
Phone
(860) 561-1007
Fax
(860) 561-1222
NPI assigned
Jul 26, 2006
Last updated
Apr 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 002269 CT Primary

Addresses

Primary practice location

1216 Farmington Ave
Room 102
West Hartford, CT 06107-2672

Mailing address

1216 Farmington Ave
Room 102
West Hartford, CT 06107-2672
Phone (860) 561-1007

Other identifiers 1

IdentifierTypeStateIssuer
004262929MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002269CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1104849553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 FARMINGTON AVE",
            "address_2": "ROOM 102",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072672",
            "telephone_number": "860-561-1007",
            "fax_number": "860-561-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 FARMINGTON AVE",
            "address_2": "ROOM 102",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072672",
            "telephone_number": "860-561-1007",
            "fax_number": "860-561-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRADINO",
        "first_name": "JOAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "002269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004262929",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.