Individual provider Active NPI

Judy Jane Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Hamden, CT
National Provider Identifier
1104860709
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
000052 Issued in CT
Practice address
275 Mount Carmel Ave
Hamden, CT 06518-1961
Phone
(203) 789-3538
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 000052 CT Primary

Addresses

Primary practice location

275 Mount Carmel Ave
Hamden, CT 06518-1961

Mailing address

673 Maple Hill Rd
Guilford, CT 06437-1635
Phone (203) 457-0494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061220000136 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163421181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000052CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2014 Accepting new patients
Somers Anesthesiology Associates, LLC Past Accepting new patients
Waterbury Anesthesiology Assoc. Inc Past Accepting new patients

Locations

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

505 Willard Ave
Newington, CT 06111
Phone (860) 224-6709

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (860) 282-4128

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

87 Grandview Ave
Waterbury, CT 06708
Phone (203) 465-1353

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1104860709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 MAPLE HILL RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371635",
            "telephone_number": "203-457-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181961",
            "telephone_number": "203-789-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JUDY",
        "middle_name": "JANE",
        "name_prefix": "Prof.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "000052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.