Individual provider Active NPI

Audrey Maureen Kemp, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1407370976
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1002565 Issued in CT
Practice address
185 Asylum St
Hartford, CT 06103-3408
Phone
(860) 573-8625
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2026

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 1002565 CT Primary

Addresses

Primary practice location

185 Asylum St
Hartford, CT 06103-3408

Mailing address

8 Wildflower Dr
Hebron, CT 06248-1449
Phone (860) 655-4615

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
I20230810001418 CT Order and Referring Only - Nurse Practitioner 6204109325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002565CTMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783123200000",
    "number": "1407370976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILDFLOWER DR",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481449",
            "telephone_number": "860-655-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 ASYLUM ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061033408",
            "telephone_number": "860-573-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "AUDREY",
        "middle_name": "MAUREEN",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "1002565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.