Individual provider Active NPI

Carol A. Kravitz, APRN

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Derby, CT
National Provider Identifier
1427203124
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
000829 Issued in CT
Practice address
30 Elizabeth St
Third Floor
Derby, CT 06418-1802
Phone
(203) 954-0543
Fax
(203) 954-0544
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 000829 CT Primary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X R48163 CT

Addresses

Primary practice location

30 Elizabeth St
Third Floor
Derby, CT 06418-1802

Mailing address

30 Elizabeth St
Third Floor
Derby, CT 06418-1802
Phone (203) 954-0543

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R48163CTMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Naugatuck Valley Parent Child Resource Center, Inc. Past Accepting new patients

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1427203124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH ST",
            "address_2": "THIRD FLOOR",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181802",
            "telephone_number": "203-954-0543",
            "fax_number": "203-954-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH ST",
            "address_2": "THIRD FLOOR",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181802",
            "telephone_number": "203-954-0543",
            "fax_number": "203-954-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVITZ",
        "first_name": "CAROL",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CT",
            "license": "000829",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CT",
            "license": "R48163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.