Individual provider Active NPI

Amy A Payson, EDD CS APRN BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1205982030
Registry record updated Dec 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
000869 Issued in CT
Practice address
2335 Black Rock Tpke
Fairfield, CT 06825-3220
Phone
(203) 373-1234
Fax
(203) 375-5619
NPI assigned
Jan 26, 2007
Last updated
Dec 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 000869 CT Primary

Addresses

Primary practice location

2335 Black Rock Tpke
Fairfield, CT 06825-3220

Mailing address

16 Old Dairy Rd
Trumbull, CT 06611-4954
Phone (203) 394-2423

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
I20040301000332 CT Practitioner - Certified Clinical Nurse Specialist (CNS) 6901793488 Practice locations: Fairfield, CT

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2335 Black Rock Tpke
Fairfield, CT 06825-3220
Phone (203) 373-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
000869CTMDClinical Psychologist
869CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy a Payson Edd CS Aprn BC LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385856000000",
    "number": "1205982030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 OLD DAIRY RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114954",
            "telephone_number": "203-394-2423",
            "fax_number": "203-375-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253220",
            "telephone_number": "203-373-1234",
            "fax_number": "203-375-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYSON",
        "first_name": "AMY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "EDD CS APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "000869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.