Stephanie Pettingle, APRN DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5676 Issued in CT

Practice address

4 Corporate Dr
Shelton, CT 06484-6211

Phone

(203) 225-0375

NPI assigned

Jan 20, 2014

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spettingle452224@direct.ynhh.org
• Direct secure messaging: stephanie.pettingle.1@27751.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Horizon Family Medicine LLC

  dba Horizon Family Medicine

  • Family Nurse Practitioner
  • East Hartford, CT
  • NPI 1942944582
  Medicare reassignment NPD Authorized official
• Connecticut Mental Health Specialists Inc

  • Psychiatry Physician
  • Farmington, CT
  • NPI 1053362814

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Griffin Faculty Physicians, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Derby, CT
  • NPI 1598755605
  Medicare reassignment NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Northeast Medical Group Inc

  • Radiation Oncology Physician
  • Greenwich, CT
  • NPI 1821390626
  NPD
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1205258605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR STE 394",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846240",
            "telephone_number": "203-225-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846211",
            "telephone_number": "203-225-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGLE",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "APRN DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-20",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338355",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personic Connecticut PLLC
• Ashley Perugini
• Peter M. Ferrara, D.D.S., L.L.C
• Rachel Petree, CRNA
• Dinko Petrov, CRNA
• Christopher Phillips, P.T.
• Kirstie Phillips, GRNA
• Jeanne Phung, LCSW
• Physical Therapy of Southern Conneticut (Child & Family Network)
• Anthony Piaty

• Family Nurse Practitioner in Shelton, CT
• Providers in Shelton, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.