Individual provider Active NPI

Emily Mellor

  • Family Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1215313796
Registry record updated Sep 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6219 Issued in CT
Practice address
114 Woodland St
Hartford, CT 06105-1208
Phone
(860) 714-4402
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2015

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 6219 CT Primary

Addresses

Primary practice location

114 Woodland St
Hartford, CT 06105-1208

Mailing address

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4402

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
I20150928002457 CT Practitioner - Nurse Practitioner 6608184403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

80 S Main St
Suite 102
Middletown, CT 06457-3648
Phone (860) 358-6878

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6219CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Aug 31, 2015 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Aug 31, 2015 Accepting new patients
Middlesex Hospital Family CurrentSince Mar 1, 2017 Accepting new patients
Middlesex Hospital CurrentSince Mar 1, 2017 Accepting new patients
Middlesex Hospital Current Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

540 Saybrook Rd
Middletown, CT 06457
Phone (860) 347-7491

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

80 S Main St
Middletown, CT 06457
Phone (860) 347-6939

540 Saybrook Rd
Ste 210
Middletown, CT 06457
Phone (860) 344-1801

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

1000 Asylum Ave
Ste 2109A
West Hartford, CT 06105
Phone (860) 714-5058

Interoperability endpoints

  • Direct secure messaging: emellor14612@middlesexhealthprd.direct-ci.com

Organizations & group practices 7

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 1

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": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441411200000",
    "number": "1215313796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOR",
        "first_name": "EMILY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.