Individual provider Active NPI

Svetlana Medved, MSPT

  • Nursing Facility/Intermediate Care Facility
  • East Hartford, CT
National Provider Identifier
1275910820
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
075257 Issued in CT
Practice address
745 Main St
East Hartford, CT 06108-3115
Phone
(860) 289-2791
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 075257 CT Primary

Addresses

Primary practice location

745 Main St
East Hartford, CT 06108-3115

Mailing address

46 Haynes Rd
West Hartford, CT 06117-2730
Phone (860) 289-2791

Other identifiers 1

IdentifierTypeStateIssuer
075257OtherCTRIVERSIDE HEALTH AND REHAB

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
075257CTMDNursing Facility/Intermediate Care Facility

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1275910820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 HAYNES RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172730",
            "telephone_number": "860-289-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083115",
            "telephone_number": "860-289-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDVED",
        "first_name": "SVETLANA",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CT",
            "license": "075257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVERSIDE HEALTH AND REHAB",
            "identifier": "075257",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.