Individual provider Active NPI

Lachanna R Evans-Cabrera, APRN

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1164075446
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8250 Issued in CT
Practice address
968 Fairfield Ave
Bridgeport, CT 06605-1116
Phone
(203) 330-6000
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8250 CT Primary

Addresses

Primary practice location

968 Fairfield Ave
Bridgeport, CT 06605-1116

Mailing address

968 Fairfield Ave
Bridgeport, CT 06605-1116
Phone (203) 330-6000

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
I20190905000769 CT Practitioner - Nurse Practitioner 8123357803 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8250CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Oct 1, 2025 Accepting new patients
South-West Community Health Center, Inc CurrentSince Aug 19, 2019 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1 Lincoln Blvd
Bridgeport, CT 06606
Phone (203) 332-5546

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

968 Fairfield Ave
Bridgeport, CT 06605

1224 Mill St
Bldg B
East Berlin, CT 06023
Phone (860) 406-4894

Interoperability endpoints

  • Direct secure messaging: levans577577@direct.ochin.org

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1164075446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS-CABRERA",
        "first_name": "LACHANNA",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.