Christine Malcolm
Individual provider Active NPI Nurse Practitioner · Stafford Springs, CT
NPI 1215604269 · NPPES record last updated Jul 21, 2023
Key facts
- NPI
- 1215604269
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 9865 (CT)
- Practice address
- 7 Magauran Dr Ste 3
Stafford Springs, CT 06076-4040 - Phone
- (860) 684-5438
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Preferred Healthcare Associates Inc
Practice addresses (Care Compare)
7 Magauran Dr
Suite 3
Stafford Springs, CT 06076-4040
Phone (413) 455-6638
Hospital & facility affiliations
- Trinity Health of New England at Home
- Johnson Memorial Hospital
- Manchester Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220120000406 | CT | Practitioner - Nurse Practitioner | 7416345004 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Healthcare Associates Inc | Current |
Accepting new patients |
Locations
7 Magauran Dr
Ste 3
Stafford Springs, CT 06076
Phone (413) 455-6638
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 9865 | CT | |
| Gerontology Nurse Practitioner | 363LG0600X | 9865 | CT | |
| Nurse Practitioner | 363L00000X | 9865 | CT | Yes |
| Acute Care Nurse Practitioner | 363LA2100X | 9865 | CT |
Addresses
Primary practice location
7 Magauran Dr Ste 3
Stafford Springs, CT 06076-4040
Mailing address
7 Magauran Dr Ste 3
Stafford Springs, CT 06076-4040
Phone (860) 684-5438
Other providers in Stafford Springs, CT
- Bethany Lewis
- Elayna Joy Lindblom
- Renee Logan
- Donna Lowney
- Ryan F Makuck
- Holly Margaret Marek
- Martha Abromaitis Dba Stafford Physical Therapy
- Kate B Mastronunzio
- Megan McCollum
- Mindful Matters Counseling, LLC
All providers in Stafford Springs, CT · Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.