Individual provider Active NPI

Stephanie Capps, APRN

  • Critical Care Pediatric Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1477553972
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
1842 Issued in CT
Practice address
114 Woodland St
Nicu
Hartford, CT 06105-1208
Phone
(860) 714-4404
Fax
(860) 714-8218
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 001842 CT
Critical Care Pediatric Nurse Practitioner 363LP0222X 1842 CT Primary

Addresses

Primary practice location

114 Woodland St
Nicu
Hartford, CT 06105-1208

Mailing address

114 Woodland St
Nicu
Hartford, CT 06105-1208
Phone (860) 714-4404

Other identifiers 1

IdentifierTypeStateIssuer
004197712MedicaidCT

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
I20090121000296 CT Practitioner - Nurse Practitioner 7517021413 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001842CTMDSurgical Physician Assistant
1842CTMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Aug 1, 2011 Accepting new patients
Day Kimball Medical Group Inc CurrentSince Mar 1, 2014 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Aug 1, 2011 Accepting new patients

Locations

132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

320 Pomfret St
#2
Putnam, CT 06260

Interoperability endpoints

  • Direct secure messaging: scapps7377@connecticutchildrens.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1477553972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "NICU",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4404",
            "fax_number": "860-714-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "NICU",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4404",
            "fax_number": "860-714-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPS",
        "first_name": "STEPHANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CT",
            "license": "001842",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CT",
            "license": "1842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004197712",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.