Individual provider Active NPI

Meridith Johnson Cowperthwait, A.P.R.N.

  • Pediatric Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1174676571
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
003009 Issued in CT
Practice address
1 Long Wharf Dr
Suite 105
New Haven, CT 06511-5991
Phone
(203) 865-3737
Fax
(203) 624-0751
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 068533 CT
Pediatric Nurse Practitioner 363LP0200X 003009 CT Primary

Addresses

Primary practice location

1 Long Wharf Dr
Suite 105
New Haven, CT 06511-5991

Mailing address

1 Long Wharf Dr
Suite 105
New Haven, CT 06511-5991
Phone (203) 865-3737

Other identifiers 2

IdentifierTypeStateIssuer
030300OtherCTCARE ID
329926OtherPREFERRED ONE

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003009CTMDPsychologist
068533CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric & Medical Associates, P.C. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: meridith.cowperthwait.1@27673.direct.athenahealth.com

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1174676571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "SUITE 105",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-865-3737",
            "fax_number": "203-624-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "SUITE 105",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-865-3737",
            "fax_number": "203-624-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWPERTHWAIT",
        "first_name": "MERIDITH",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "068533",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "003009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTCARE ID",
            "identifier": "030300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "329926",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.