Organization Active NPI

Connecticut Clinical Nursing Associates, LLC

  • Nurse Practitioner
  • Plymouth, CT
National Provider Identifier
1346315231
Registry record updated Jul 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
000638 Issued in CT
Legal business name
CONNECTICUT CLINICAL NURSING ASSOCIATES, LLC
Practice address
204 Keegan Rd
Plymouth, CT 06782-2608
Phone
(860) 340-8280
NPI assigned
Nov 23, 2006
Last updated
Jul 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2008

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

Authorized official

Name
Catherine Milne, APRNNPI 1659336303
Title
Member
Phone
(860) 340-8280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 000638 CT Primary
Nurse Practitioner 363L00000X 002938 CT
Family Nurse Practitioner 363LF0000X 003747 CT
Clinical Nurse Specialist 364S00000X 001126 CT
Clinical Nurse Specialist 364S00000X 002671 CT

Addresses

Primary practice location

204 Keegan Rd
Plymouth, CT 06782-2608

Mailing address

PO Box 1535
Bristol, CT 06011-1535
Phone (860) 340-8280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050302000659 CT Part B Supplier - Clinic/Group Practice 3678526571 Receives reassigned benefits from 3 practitioners
Practice locations: West Hartford, CT; Waterbury, CT; Torrington, CT; Bristol, CT; Southington, CT; Southbury, CT; Plymouth, CT; Simsbury, CT…

National Provider Directory

National Provider Directory

Locations

31 North St
Litchfield, CT 06759
Phone (860) 567-9475

2817 N Main St
Waterbury, CT 06704
Phone (203) 757-0731

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217116800000",
    "number": "1346315231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060111535",
            "telephone_number": "860-340-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 KEEGAN RD",
            "city": "PLYMOUTH",
            "state": "CT",
            "postal_code": "067822608",
            "telephone_number": "860-340-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT CLINICAL NURSING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-23",
        "last_updated": "2008-07-27",
        "status": "A",
        "authorized_official_last_name": "MILNE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-340-8280",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "000638",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002938",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003747",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CT",
            "license": "001126",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CT",
            "license": "002671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.