Individual provider Active NPI

Cathy Kiernozek, APRN

  • Adult Health Nurse Practitioner
  • Rocky Hill, CT
National Provider Identifier
1346659778
Registry record updated Nov 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5818 Issued in CT
Practice address
400 Capital Blvd
Rocky Hill, CT 06067-3576
Phone
(860) 221-0549
Fax
(855) 247-8787
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5818 CT
Adult Health Nurse Practitioner 363LA2200X 5818 CT Primary

Addresses

Primary practice location

400 Capital Blvd
Rocky Hill, CT 06067-3576

Mailing address

345 Winding RDG
Southington, CT 06489-2180
Phone (860) 839-0781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150113000961 CT Order and Referring Only - Nurse Practitioner 9133443542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5818CTMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541203200000",
    "number": "1346659778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WINDING RDG",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892180",
            "telephone_number": "860-839-0781",
            "fax_number": "855-232-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "860-221-0549",
            "fax_number": "855-247-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNOZEK",
        "first_name": "CATHY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2018-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "5818",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "5818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

Verify at the official NPI Registry.