Individual provider Active NPI

Jodi Lynn Iaccarino, RN

  • Rehabilitation Registered Nurse
  • Westbrook, CT
National Provider Identifier
1114236411
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Registered NurseTaxonomy code 163WR0400X
License
E45850 Issued in CT
Practice address
1856 Boston Post Rd
Westbrook, CT 06498-2101
Phone
(860) 399-0600
Fax
(860) 399-0600
NPI assigned
Oct 4, 2010
Last updated
Oct 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X E45850 CT Primary

Addresses

Primary practice location

1856 Boston Post Rd
Westbrook, CT 06498-2101

Mailing address

118 Williams Dr
Guilford, CT 06437-1401
Phone (203) 457-9401

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
E45850CTMDRehabilitation Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1114236411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WILLIAMS DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371401",
            "telephone_number": "203-457-9401",
            "fax_number": "203-457-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 BOSTON POST RD",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064982101",
            "telephone_number": "860-399-0600",
            "fax_number": "860-399-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACCARINO",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "CT",
            "license": "E45850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.