Individual provider Active NPI

Sylvia K Parker, GNP-BC

  • Gerontology Nurse Practitioner
  • Wallingford, CT
National Provider Identifier
1437308186
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
003894 Issued in CT
Practice address
22 Masonic Ave
Wallingford, CT 06492
Phone
(203) 679-5900
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 003894 CT Primary

Addresses

Primary practice location

22 Masonic Ave
Wallingford, CT 06492

Mailing address

400 Capital Blvd
Rocky Hill, CT 06067-3576
Phone (203) 687-7875

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
I20241219000815 CT Order and Referring Only - Nurse Practitioner 4688723364

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3894CTMDOccupational Therapist
003894CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients

Organizations & group practices 2

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1437308186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "203-687-7875",
            "fax_number": "844-731-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-679-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SYLVIA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "003894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.