CT Family Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

004732 Issued in CT

Legal business name

CT FAMILY CARE LLC

Practice address

281 Hartford Tpke
Suite 306
Vernon, CT 06066-4784

Phone

(860) 454-8621

Fax

(860) 926-4725

NPI assigned

Jan 23, 2012

Organization subpart

No

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

Authorized official

Name

Mr. JT Mohler-Avery, MSN, APRN, FNP-BC

Title

Ceo/Managing Member

Phone

(860) 985-7080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1245501279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664784",
            "telephone_number": "860-454-8621",
            "fax_number": "860-926-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE",
            "address_2": "SUITE 306",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664784",
            "telephone_number": "860-454-8621",
            "fax_number": "860-926-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "MOHLER-AVERY",
        "authorized_official_first_name": "JT",
        "authorized_official_title_or_position": "CEO/MANAGING MEMBER",
        "authorized_official_telephone_number": "860-985-7080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN, APRN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connecticut East Dental Center, LLC
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• Lauren Roselle Crespo, PHARMD
• Ctuc01
• Jarod Michael D'Agostino, MS, ATC
• Justin Damon, APRN
• Kathleen Dang, O.D.
• Adam Seacat Daniels, D.D.S., M.S.

• Family Nurse Practitioner in Vernon, CT
• Providers in Vernon, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.