Individual provider Active NPI

Jennifer Wethje, APRN, FNP

  • Family Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1235419557
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004695 Issued in CT
Practice address
8 Two Mile Rd Ste 204
Farmington, CT 06032-2559
Phone
(860) 507-1550
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 004695 CT
Family Nurse Practitioner 363LF0000X 004695 CT Primary

Addresses

Primary practice location

8 Two Mile Rd Ste 204
Farmington, CT 06032-2559

Mailing address

175 Capital Blvd FL 3
Rocky Hill, CT 06067-3914
Phone (860) 678-3400

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
I20120402000352 CT Practitioner - Nurse Practitioner 3375703135 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4695CTMDPeriodontist
004695CTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Family CurrentSince Dec 4, 2012 Accepting new patients
Women'S Health of Central Ma. PC PastSince Jan 14, 2024 Accepting new patients

Locations

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

8 Two Mile Rd
Ste 204
Farmington, CT 06032
Phone (860) 246-8568

8 Two Mile Rd
Farmington, CT 06032

330 Western Blvd
Ste 102
Glastonbury, CT 06033
Phone (860) 547-0306

175 Capital Blvd
Fl 3
Rocky Hill, CT 06067

Interoperability endpoints

  • Direct secure messaging: jennifer.wethje.2@10170.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1235419557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CAPITAL BLVD FL 3",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673914",
            "telephone_number": "860-678-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TWO MILE RD STE 204",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322559",
            "telephone_number": "860-507-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETHJE",
        "first_name": "JENNIFER",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "004695",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.