Individual provider Active NPI

Abby Ann Gloria, NP-C

  • Family Nurse Practitioner
  • Danielson, CT
National Provider Identifier
1265785299
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005182 Issued in CT
Practice address
54 Reynolds St
Danielson, CT 06239-2917
Phone
(860) 774-7501
Fax
(860) 779-2191
NPI assigned
Oct 15, 2012
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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 005182 CT Primary

Addresses

Primary practice location

54 Reynolds St
Danielson, CT 06239-2917

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018

Other identifiers 1

IdentifierTypeStateIssuer
008043568MedicaidCT

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
I20130715000764 CT Practitioner - Nurse Practitioner 7618117656

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005182CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Killingly Eye Care P.C. Past Accepting new patients
Generations Family Health Center Inc Past Accepting new patients

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, 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": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1265785299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 REYNOLDS ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392917",
            "telephone_number": "860-774-7501",
            "fax_number": "860-779-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLORIA",
        "first_name": "ABBY",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008043568",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.