Individual provider Active NPI

Shawn Polizzi, APRN

  • Women's Health Nurse Practitioner
  • Branford, CT
National Provider Identifier
1164458386
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
002996 Issued in CT
Practice address
1090 Main St
Branford, CT 06405-3716
Phone
(203) 848-8704
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 002996 CT Primary

Addresses

Primary practice location

1090 Main St
Branford, CT 06405-3716

Mailing address

1090 Main St
Branford, CT 06405-3716
Phone (203) 848-8704

Other identifiers 1

IdentifierTypeStateIssuer
004250065MedicaidCT

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002996CTMDSchool Social Worker
2996CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Women'S Health PastSince Apr 2, 2018 Accepting new patients
Women'S Health Center, PC PastSince May 18, 2015 Accepting new patients

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1164458386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053716",
            "telephone_number": "203-848-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053716",
            "telephone_number": "203-848-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZZI",
        "first_name": "SHAWN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "002996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004250065",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.