Active NPI
Virginia Rose Shea, APRN
- Primary Care Nurse Practitioner
- Putnam, CT
National Provider Identifier
1306964580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 003084
- Practice address
- 346 Pomfret St
Putnam, CT 06260-1871 - Phone
- (860) 928-4344
- Fax
- (860) 928-4188
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 003084 | CT | Primary |
Addresses
Primary practice location
346 Pomfret St
Putnam, CT 06260-1871
Mailing address
320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 779-9270
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003084 | CT | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1306964580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 POMFRET ST",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601836",
"telephone_number": "860-779-9270",
"fax_number": "860-779-7597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "346 POMFRET ST",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601871",
"telephone_number": "860-928-4344",
"fax_number": "860-928-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "VIRGINIA",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "003084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.