Jennell Ifill, RN

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

83247 Issued in CT

Practice address

350 North St
Windsor Locks, CT 06096-1229

Phone

(860) 218-0000

NPI assigned

Mar 21, 2024

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Holistic Healthcare

  • Primary Care Clinic/Center
  • Windsor Locks, CT
  • NPI 1619653417
  NPD Authorized official

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1306606553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NORTH ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060961229",
            "telephone_number": "860-967-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NORTH ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060961229",
            "telephone_number": "860-218-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFILL",
        "first_name": "JENNELL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CT",
            "license": "83247",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CT",
            "license": "83247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Happy Adams Transportation of Windsor Locks L L C
• Rebecca Michelle Harpin
• Healthy Smiles Dental Care, P.C.
• Holistic Healthcare
• House of Eve
• Jaquar Limo LLC
• Sheldon Kafer, M.D.
• Samantha Killen
• Chung K Kim, D.M.D.
• Janet Konadu, REGISTERED NURSE

• Health & Wellness Coach in Windsor Locks, CT
• Providers in Windsor Locks, CT by specialty
• Health & Wellness Coach in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.