Individual provider Active NPI

Melissa Ann Lonergan, APRN CNM

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1104893825
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000066 Issued in CT
Practice address
374 Grand Ave
Fair Haven Community Health Center
New Haven, CT 06513
Phone
(203) 777-7411
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 000066 CT Primary

Addresses

Primary practice location

374 Grand Ave
Fair Haven Community Health Center
New Haven, CT 06513

Mailing address

45 Sunset Beach Rd
Branford, CT 06405-5028
Phone (203) 488-3231

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000066CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Healthcare System Affiliated Physicians Inc Advanced Practice Midwife Past Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Organizations & group practices 2

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104893825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SUNSET BEACH RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064055028",
            "telephone_number": "203-488-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "address_2": "FAIR HAVEN COMMUNITY HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06513",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONERGAN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "APRN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.