Individual provider Active NPI

Katharine Nicole Vardanian, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Storrs, CT
National Provider Identifier
1205869112
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
001111 Issued in CT
Practice address
1 Royce Cir Ste 104
Storrs, CT 06268-2270
Phone
(860) 487-9200
Fax
(860) 487-9222
NPI assigned
Jul 7, 2006
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 001111 CT Primary

Addresses

Primary practice location

1 Royce Cir Ste 104
Storrs, CT 06268-2270

Mailing address

1 Royce Cir Ste 104
Storrs, CT 06268-2270
Phone (860) 487-9200

Other identifiers 2

IdentifierTypeStateIssuer
004025144MedicaidCT
500000608OtherCTAMA #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstephenson40305@direct.med.uchc.edu

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
I20110406000735 CT Practitioner - Nurse Practitioner 4981888534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Royce Cir
Suite 104
Storrs, CT 06268-2270
Phone (860) 487-9200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Aug 1, 2020 Accepting new patients
University of Connecticut Health Center CurrentSince Aug 1, 2020 Accepting new patients
University of Connecticut Health Center Past Accepting new patients
Southeastern CT Nephrology Assoc. PastSince Mar 1, 2016 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

1 Royce Cir
Ste 104
Storrs Mansfield, CT 06268
Phone (860) 487-9200

Interoperability endpoints

  • Direct secure messaging: kstephenson40305@direct.med.uchc.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1205869112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROYCE CIR STE 104",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062682270",
            "telephone_number": "860-487-9200",
            "fax_number": "860-487-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROYCE CIR STE 104",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062682270",
            "telephone_number": "860-487-9200",
            "fax_number": "860-487-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDANIAN",
        "first_name": "KATHARINE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "001111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004025144",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMA #",
            "identifier": "500000608",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstephenson40305@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Storrs, CT

Sources for this page

Verify at the official NPI Registry.