Individual provider Active NPI

Meagan Carroll, APRN

  • Gerontology Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1346750510
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
7262 Issued in CT
Practice address
2150 Black Rock Tpke
Fairfield, CT 06825-3255
Phone
(120) 338-4222
NPI assigned
Oct 2, 2017
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 7262 CT Primary

Addresses

Primary practice location

2150 Black Rock Tpke
Fairfield, CT 06825-3255

Mailing address

71 Arrowhead PL
Stratford, CT 06614-2804
Phone (781) 354-9708

Other names 1

  • Meagan Huntley Former name

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
I20171211000879 CT Practitioner - Nurse Practitioner 3274891791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adam Bard MD LLCGroup PAC ID 4587674346, 2 clinicians

Practice addresses (Care Compare)

2150 Black Rock Tpke
Fairfield, CT 06825-3255
Phone (203) 384-2227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7262CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Bard, MD LLC CurrentSince Aug 5, 2019 Accepting new patients

Locations

2150 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 334-7400

2150 Black Rock Tpke
Rm 301
Fairfield, CT 06825
Phone (203) 384-2227

Interoperability endpoints

  • Direct secure messaging: mcarroll325393@direct.ynhh.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1346750510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ARROWHEAD PL",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066142804",
            "telephone_number": "781-354-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253255",
            "telephone_number": "120-338-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MEAGAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2024-06-10",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "HUNTLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.