Active NPI
Jennifer S Wilner, M.D.
- Pediatrics Physician
- West Hartford, CT
National Provider Identifier
1114188240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 054316
- Practice address
- 785 Farmington Ave
West Hartford, CT 06119-1673 - Phone
- (860) 523-4100
- Fax
- (860) 523-1462
- NPI assigned
- Jun 20, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 248854 | NY | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 54316 | CT | |
| Pediatrics Physician | 208000000X | 054316 | CT | Primary |
Addresses
Primary practice location
785 Farmington Ave
West Hartford, CT 06119-1673
Mailing address
785 Farmington Ave
West Hartford, CT 06119-1673
Phone (860) 523-4100
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054316 | CT | MD | Pediatrics Physician |
| 248854 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Hartford Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1114188240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 FARMINGTON AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061191673",
"telephone_number": "860-523-4100",
"fax_number": "860-523-1462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 FARMINGTON AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061191673",
"telephone_number": "860-523-4100",
"fax_number": "860-523-1462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILNER",
"first_name": "JENNIFER",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-20",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "248854",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CT",
"license": "54316",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "054316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.