Individual provider Active NPI

Heather Eckenrode, APRN

  • Family Nurse Practitioner
  • Derby, CT
National Provider Identifier
1194242008
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9306 Issued in CT
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-1330
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2295575 MA
Family Nurse Practitioner 363LF0000X 9306 CT Primary

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

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

Other names 1

  • Heather Hunt Former name

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
I20210405000330 CT Practitioner - Nurse Practitioner 7012252547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1352

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
9306CTMDPhysical Therapist
2295575MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Wound Care LLC CurrentSince Nov 29, 2023 Accepting new patients
Griffin Faculty Physicians, Inc. CurrentSince May 9, 2022 Accepting new patients
Pulmonary Care, PC PastSince Apr 10, 2011 Accepting new patients

Locations

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

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

20 Commerce Park
Ste 1
Milford, CT 06460
Phone (203) 951-8360

136 Sherman Ave
Ste 504
New Haven, CT 06511
Phone (203) 684-2111

67 Masonic Ave
Ste 2400
Wallingford, CT 06492
Phone (203) 284-3159

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.

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1194242008",
    "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": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKENRODE",
        "first_name": "HEATHER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2295575",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "HUNT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.