Fara Philidor, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

17840 Issued in CT

Practice address

1 Shaws CV
New London, CT 06320-4902

Phone

(860) 447-8304

Fax

(860) 443-8720

NPI assigned

Jul 6, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1275451502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GRAND ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572705",
            "telephone_number": "860-347-6971",
            "fax_number": "860-343-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHAWS CV",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204902",
            "telephone_number": "860-447-8304",
            "fax_number": "860-443-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIDOR",
        "first_name": "FARA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "17840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah M. Peterson, RD, CDE
• Rene Petrone, COTA/L
• Latisha Monique Pettway, CRNA
• Emily M Pfannenstiel, BA
• Sydney Phelps, LMSW
• Kim Picard
• Trent Pierce, HS
• Amy A Piersa, LCSW
• Sharma Piersall, LMSW
• Suzanne Marie Pinkston

• Nurse Practitioner in New London, CT
• Providers in New London, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.