Active NPI
Janet Tibbetts, APRN
- Pediatric Nurse Practitioner
- Middletown, CT
National Provider Identifier
1316958614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 000142
- Practice address
- 400 Saybrook Rd
Suite 206
Middletown, CT 06457-4773 - Phone
- (860) 344-0333
- Fax
- (860) 344-9703
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 000142 | CT | Primary |
Addresses
Primary practice location
400 Saybrook Rd
Suite 206
Middletown, CT 06457-4773
Mailing address
4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200
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 |
|---|---|---|---|
| 000142 | CT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1316958614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 FARM SPRINGS RD",
"address_2": "PROHEALTH PHYSICIANS",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322573",
"telephone_number": "860-284-5200",
"fax_number": "860-284-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SAYBROOK RD",
"address_2": "SUITE 206",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064574773",
"telephone_number": "860-344-0333",
"fax_number": "860-344-9703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBETTS",
"first_name": "JANET",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "000142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.