Stephanie Adams, APRN
Individual provider Active NPI Family Nurse Practitioner · Norwich, CT
NPI 1467946152 · NPPES record last updated Jul 24, 2020
Key facts
- NPI
- 1467946152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1234 (CT)
- Practice address
- 624 W Main St Ste 140
Norwich, CT 06360-6043 - Phone
- (860) 200-8098
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181101002377 | CT | Practitioner - Nurse Practitioner | 4789937194 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7656 | CT | MD | Counselor |
| 1234 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flanders Pediatrics LLC | Past | Accepting new patients |
Interoperability endpoints
- stephanie.adams.1@11789.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1234 | CT | Yes |
Addresses
Primary practice location
624 W Main St Ste 140
Norwich, CT 06360-6043
Mailing address
1290 Silas Deane Hwy Ste 102
Wethersfield, CT 06109-4337
Phone (860) 972-6977
Other practice location 1
42 Town St Ste 300
Norwich, CT 06360-2339
Phone (860) 886-0567
Other names
- Stephanie Pollard
Other providers in Norwich, CT
- Abera H Abay
- Bethany Ackley
- Julie Rose Adams
- Lisa Adams
- Mariah Adams
- Adaptive Prosthetics & Orthotics LLC
- Advanced Community Support, LLC
- Advanced Dermatology LLC
- Advantage Dental Group, LLC
- Affinity Behavioral Health, LLC
All providers in Norwich, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.