Individual provider Active NPI

Desiree Lynn Lavery, NP-C

  • Nurse Practitioner
  • Thomaston, CT
National Provider Identifier
1265929533
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12.007545 Issued in CT
Practice address
205 S Main St
Thomaston, CT 06787-1740
Phone
(860) 283-6255
NPI assigned
Apr 22, 2018
Last updated
May 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12.007545 CT Primary

Addresses

Primary practice location

205 S Main St
Thomaston, CT 06787-1740

Mailing address

205 S Main St
Thomaston, CT 06787-1740
Phone (860) 384-0300

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
I20180509000957 CT Practitioner - Nurse Practitioner 2264796739 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians

Practice addresses (Care Compare)

101 Centerpoint Dr
Suite 215
Middletown, CT 06457-7568
Phone (888) 964-6681

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12.007545CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Nurse Practitioner CurrentSince Jun 18, 2022 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 1, 2025 Accepting new patients
Prospect CT Medical Foundation, Inc. Nurse Practitioner CurrentSince May 10, 2019 Accepting new patients
Healthdrive Medical Services Southeast LLC Nurse Practitioner CurrentSince Aug 1, 2025 Accepting new patients
Careconnectmd Connecticut PC CurrentSince Jun 21, 2023 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000

Interoperability endpoints

  • Direct secure messaging: desireelavery@amggw.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1265929533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871740",
            "telephone_number": "860-384-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871740",
            "telephone_number": "860-283-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERY",
        "first_name": "DESIREE",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-22",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "12.007545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, CT

Sources for this page

Verify at the official NPI Registry.