Individual provider Active NPI

Jennifer L Nelson, APRN

  • Adult Health Nurse Practitioner
  • Oxford, CT
National Provider Identifier
1164409587
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3304 Issued in CT
Practice address
220 Main St Ste 1a
Oxford, CT 06478-1065
Phone
(203) 888-5527
Fax
(203) 888-3727
NPI assigned
Dec 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3304 CT Primary
Registered Nurse 163W00000X 3304 CT
Family Nurse Practitioner 363LF0000X 003304 CT

Addresses

Primary practice location

220 Main St Ste 1a
Oxford, CT 06478-1065

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-7325

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
I20051012000819 CT Practitioner - Nurse Practitioner 1850316415 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

220 Main St
Suite 1a
Oxford, CT 06478-1065
Phone (203) 888-5527

Hospital & facility affiliations

  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3304CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Feb 17, 2010 Accepting new patients
Griffin Faculty Physicians, Inc. Adult Health CurrentSince Jan 10, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Jul 1, 2017 Accepting new patients
Yale University CurrentSince Feb 17, 2010 Accepting new patients
Yale University Past Accepting new patients

Locations

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

130 Division St
Derby, CT 06418
Phone (203) 732-1330

5 Durham Rd
Ste C2
Guilford, CT 06437
Phone (203) 488-4334

111 Goose Ln
Ste 2400
Guilford, CT 06437
Phone (203) 458-2097

9 Washington Ave
Ste 3A
Hamden, CT 06518
Phone (475) 227-3614

131 Bridge St
Naugatuck, CT 06770
Phone (203) 729-0755

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

220 Main St
Ste 1A
Oxford, CT 06478
Phone (203) 888-5527

12 Lathrop Rd
Plainfield, CT 06374
Phone (860) 457-9150

4 Corporate Dr
Ste 283
Shelton, CT 06484
Phone (203) 773-3055

2 Ivy Brook Rd
Ste 120
Shelton, CT 06484
Phone (203) 513-2642

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

863 N Main Street Ext
Ste 101
Wallingford, CT 06492
Phone (203) 269-3791

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: jennifer.nelson@xdr.hhchealthdirect.org
  • Direct secure messaging: jennifer.nelson.1@1323.direct.athenahealth.com

Organizations & group practices 7

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 4

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1164409587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MAIN ST STE 1A",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781065",
            "telephone_number": "203-888-5527",
            "fax_number": "203-888-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "3304",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "3304",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, CT

Sources for this page

Verify at the official NPI Registry.