Individual provider Active NPI

Stephanie Larose

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1235647181
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7378 Issued in CT
Practice address
2979 Main St
Bridgeport, CT 06606-4284
Phone
(203) 382-2345
NPI assigned
Jan 12, 2018
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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 7378 CT Primary

Addresses

Primary practice location

2979 Main St
Bridgeport, CT 06606-4284

Mailing address

157 Church St
FL 19
New Haven, CT 06510-2100
Phone (866) 949-0108

Other practice location 1

157 Church St Fl 19
New Haven, CT 06510-2100
Phone (866) 949-0108

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
I20180226000081 CT Practitioner - Nurse Practitioner 4385905876 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Family CurrentSince Feb 1, 2018 Accepting new patients
Amazing Victory LLC CurrentSince Jul 27, 2024 Accepting new patients
Step Up Care PC LLC CurrentSince Dec 1, 2020 Accepting new patients
Northeast Neuropsychology, LLC CurrentSince Mar 4, 2024 Accepting new patients
Harvest Healthcare LLC CurrentSince Feb 28, 2023 Accepting new patients
Advanced Telepsych PLLC CurrentSince Mar 4, 2024 Accepting new patients
Brighter Day LLC CurrentSince Dec 24, 2023 Accepting new patients
Prohealth Physicians PC Family PastSince Jun 7, 2023 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

2979 Main St
Bridgeport, CT 06606
Phone (203) 333-8800

609 W Johnson Ave
Ste 104
Cheshire, CT 06410
Phone (203) 272-6007

1201 Kings Hwy
Ste 2
Fairfield, CT 06824
Phone (203) 243-4909

770 Saybrook Rd
Middletown, CT 06457
Phone (888) 344-3893

157 Church St
Fl 19
New Haven, CT 06510
Phone (475) 319-4067

169 Davenport Ave
New Haven, CT 06519
Phone (203) 789-1650

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

1041 Broadway
Woodmere, NY 11598
Phone (203) 568-6065

Interoperability endpoints

  • Direct secure messaging: ms_slarose2@landmarkhealth-direct.org
  • Direct secure messaging: stephanie.larose@xdr.hhchealthdirect.org

Organizations & group practices 8

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1235647181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CHURCH ST",
            "address_2": "FL 19",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102100",
            "telephone_number": "866-949-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064284",
            "telephone_number": "203-382-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Church St Fl 19",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102100",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.