Active NPI
Beth Ann J Podsobinski, APRN BC
- Psychiatric/Mental Health Nurse Practitioner
- New London, CT
National Provider Identifier
1447265376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 001412
- Practice address
- 490 Jefferson St
New London High School-Based Health Center
New London, CT 06320 - Phone
- (860) 701-3771
- Fax
- (860) 701-3771
- NPI assigned
- Jul 29, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | TP003699N | PA | |
| Pediatric Nurse Practitioner | 363LP0200X | 001412 | CT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 001412 | CT | Primary |
Addresses
Primary practice location
490 Jefferson St
New London High School-Based Health Center
New London, CT 06320
Mailing address
34 Third Ave
Waterford, CT 06385
Phone (860) 437-0446
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP003699N | PA | MD | Pediatric Nurse Practitioner |
| 001412 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1447265376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 THIRD AVE",
"city": "WATERFORD",
"state": "CT",
"postal_code": "06385",
"telephone_number": "860-437-0446",
"fax_number": "860-701-3776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 JEFFERSON ST",
"address_2": "NEW LONDON HIGH SCHOOL-BASED HEALTH CENTER",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "06320",
"telephone_number": "860-701-3771",
"fax_number": "860-701-3771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODSOBINSKI",
"first_name": "BETH ANN",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "APRN BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-29",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "TP003699N",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "001412",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CT",
"license": "001412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.