Active NPI
Mary Catherine Lavery, APRN
- Clinical Nurse Specialist
- Glastonbury, CT
National Provider Identifier
1346608692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 004359
- Practice address
- 628 Hebron Ave
Glastonbury, CT 06033 - Phone
- (860) 494-4600
- NPI assigned
- Feb 2, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 004359 | CT | Primary |
| Oncology Clinical Nurse Specialist | 364SX0200X | 004359 | CT |
Addresses
Primary practice location
628 Hebron Ave
Glastonbury, CT 06033
Mailing address
628 Hebron Ave
Glastonbury, CT 06033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004359 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454371200000",
"number": "1346608692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 HEBRON AVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 HEBRON AVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-494-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVERY",
"first_name": "MARY",
"middle_name": "CATHERINE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-02",
"last_updated": "2016-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "CT",
"license": "004359",
"primary": true
},
{
"code": "364SX0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Oncology",
"state": "CT",
"license": "004359",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.