Individual provider Active NPI

Teresa Jean Marks, FNP-C, APRN, RN

  • Family Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1396558128
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14320 Issued in CT
Practice address
2000 N Main St Ste a
Waterbury, CT 06704-2364
Phone
(203) 951-8306
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14320 CT Primary

Addresses

Primary practice location

2000 N Main St Ste a
Waterbury, CT 06704-2364

Mailing address

PO Box 745254
Atlanta, GA 30374-5254

Other practice location 1

260 Fern Hill Rd
Bristol, CT 06010-3116
Phone (860) 690-7447

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
I20260320001550 CT Practitioner - Nurse Practitioner 0648754374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Physician Group PLLCGroup PAC ID 7810428166, 10 clinicians

Practice addresses (Care Compare)

2000 N Main St
Suite a
Waterbury, CT 06704-2364
Phone (203) 951-8306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14320CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Physician Group PLLC CurrentSince Dec 21, 2025 Accepting new patients

Locations

2000 N Main St
#A
Waterbury, CT 06704
Phone (203) 951-8306

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1396558128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745254",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N MAIN ST STE A",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067042364",
            "telephone_number": "203-951-8306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Fern Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060103116",
            "country_code": "US",
            "telephone_number": "860-690-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "TERESA",
        "middle_name": "JEAN",
        "credential": "FNP-C, APRN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "14320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.