Individual provider Active NPI

Marissa Lahaie, APRN

  • Adult Health Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1114208758
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4781 Issued in CT
Practice address
330 Pomfret St
Putnam, CT 06260-1854
Phone
(860) 928-2736
NPI assigned
Sep 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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 4781 CT Primary

Addresses

Primary practice location

330 Pomfret St
Putnam, CT 06260-1854

Mailing address

330 Pomfret St
Putnam, CT 06260-1854
Phone (860) 928-2736

Other identifiers 1

IdentifierTypeStateIssuer
008035051MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251128000219 NH Practitioner - Nurse Practitioner 9133392236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

245 Rochester Hill Rd
Suite 1a
Rochester, NH 03867-1709
Phone (603) 335-2401

Hospital & facility affiliations

  • Cornerstone Vna Home health agency, Rochester, NH, CCN 307022
  • Frisbie Memorial Hospital Hospital, Rochester, NH, CCN 300014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4781CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group, Inc CurrentSince Nov 10, 2025 Accepting new patients
Appledore Medical Group, Inc. CurrentSince Nov 10, 2025 Accepting new patients

Locations

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

245 Rochester Hill Rd
Ste 1A
Rochester, NH 03867

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: marissa.lahaie@hca6.eclinicaldirectplus.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1114208758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601854",
            "telephone_number": "860-928-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601854",
            "telephone_number": "860-928-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHAIE",
        "first_name": "MARISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "4781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008035051",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.