Individual provider Active NPI

Kripa Plapetta Damodharan, DNP-FNP

  • Family Nurse Practitioner
  • West Haven, CT
National Provider Identifier
1457752107
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5910 Issued in CT
Practice address
764 Campbell Ave Ste F
West Haven, CT 06516-3786
Phone
(203) 443-9500
Fax
(203) 902-0509
NPI assigned
Sep 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5910 CT Primary
Family Nurse Practitioner 363LF0000X 4897 RI

Addresses

Primary practice location

764 Campbell Ave Ste F
West Haven, CT 06516-3786

Mailing address

764 Campbell Ave Ste F
West Haven, CT 06516-3786
Phone (203) 443-9500

Other practice location 1

255 Robbins St
Waterbury, CT 06708-2762
Phone (203) 443-9500

Other practice location 2

3 Crestview Dr
Westerly, RI 02891-2907
Phone (203) 295-7855

Other identifiers 1

IdentifierTypeStateIssuer
008055517MedicaidCT

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
I20141107000852 CT Practitioner - Nurse Practitioner 2769604727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Livwell Pain Management LLCGroup PAC ID 3476883265, 3 clinicians

Practice addresses (Care Compare)

764 Campbell Ave
Suite F
West Haven, CT 06516-3786
Phone (203) 443-9500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5910CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Outcomes, LLC Past Accepting new patients
Pain RX Center Family Past Accepting new patients

Organizations & group practices 3

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1457752107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 CAMPBELL AVE STE F",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163786",
            "telephone_number": "203-443-9500",
            "fax_number": "203-902-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 CAMPBELL AVE STE F",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163786",
            "telephone_number": "203-443-9500",
            "fax_number": "203-902-0509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Robbins St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082762",
            "country_code": "US",
            "telephone_number": "203-443-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Crestview Dr",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912907",
            "country_code": "US",
            "telephone_number": "203-295-7855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLAPETTA DAMODHARAN",
        "first_name": "KRIPA",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5910",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "4897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008055517",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.