Individual provider Active NPI

Jessica Angela Nichole Fett, APRN

  • Family Nurse Practitioner
  • Enfield, CT
National Provider Identifier
1184798449
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
003542 Issued in CT
Practice address
5 N Main St
Enfield, CT 06082-3372
Phone
(860) 253-9024
Fax
(860) 253-9593
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2280255 MA
Family Nurse Practitioner 363LF0000X 003542 CT Primary

Addresses

Primary practice location

5 N Main St
Enfield, CT 06082-3372

Mailing address

5 N Main St
Enfield, CT 06082-3372
Phone (860) 253-9024

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9200

Other identifiers 4

IdentifierTypeStateIssuer
103542OtherCTCONNECTICARE
1255448155OtherCTGHMC GROUP NPI
3V0058OtherCTHEALTH NET
004264529MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfett47149@connecticutchildrens.direct-ci.com

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
I20061215000312 CT Practitioner - Nurse Practitioner 2769481902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3542CTMDProfessional Counselor
003542CTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hampden County Physician Associates, LLC. Past Accepting new patients
Hartford Physician Services PC Nurse Practitioner Past Accepting new patients
Hampden County Physician Associates, LLC Past Accepting new patients

Organizations & group practices 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1184798449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 N MAIN ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823372",
            "telephone_number": "860-253-9024",
            "fax_number": "860-253-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 N MAIN ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823372",
            "telephone_number": "860-253-9024",
            "fax_number": "860-253-9593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9200",
            "fax_number": "860-545-9202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FETT",
        "first_name": "JESSICA",
        "middle_name": "ANGELA NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2280255",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "103542",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMC GROUP NPI",
            "identifier": "1255448155",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3V0058",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004264529",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfett47149@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.