Active NPI
Amanda Beth Tini, APRN
- Pediatric Nurse Practitioner
- East Hartford, CT
National Provider Identifier
1427177526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 002648
- Practice address
- 763 Burnside Ave
East Hartford, CT 06108-2791 - Phone
- (860) 291-9787
- Fax
- (860) 291-9728
- NPI assigned
- Mar 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 002648 | CT | Primary |
Addresses
Primary practice location
763 Burnside Ave
East Hartford, CT 06108-2791
Mailing address
763 Burnside Ave
East Hartford, CT 06108-2791
Phone (860) 291-9787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002648 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440460800000",
"number": "1427177526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "763 BURNSIDE AVE",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "061082791",
"telephone_number": "860-291-9787",
"fax_number": "860-291-9728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "763 BURNSIDE AVE",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "061082791",
"telephone_number": "860-291-9787",
"fax_number": "860-291-9728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINI",
"first_name": "AMANDA",
"middle_name": "BETH",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2015-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "002648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.