Individual provider Active NPI

Kathryn Ann Kerins

  • Gerontology Nurse Practitioner
  • New Milford, CT
National Provider Identifier
1114776218
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
13091 Issued in CT
Practice address
21 Elm St
New Milford, CT 06776-2915
Phone
(860) 210-5300
NPI assigned
May 13, 2024
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 13091 CT Primary

Addresses

Primary practice location

21 Elm St
New Milford, CT 06776-2915

Mailing address

35 Hearthstone Dr
Brookfield, CT 06804-3007
Phone (203) 770-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240610003618 CT Practitioner - Nurse Practitioner 6002358728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

21 Elm St
New Milford, CT 06776-2915
Phone (860) 210-5390

50 Hospital Hill Rd
Sharon, CT 06069-2096
Phone (860) 364-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Nurse Practitioner CurrentSince Jul 21, 2024 Accepting new patients
Nuvance Health Medical Practice PC Nurse Practitioner CurrentSince Jul 21, 2024 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

50 Hospital Hill Rd
Sharon, CT 06069
Phone (860) 364-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1114776218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HEARTHSTONE DR",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068043007",
            "telephone_number": "203-770-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ELM ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762915",
            "telephone_number": "860-210-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERINS",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "13091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.