Individual provider Active NPI

Melinda Ethel Brockwell, APRN

  • Clinical Nurse Specialist
  • Norwalk, CT
National Provider Identifier
1487858361
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
003545 Issued in CT
Practice address
24 Stevens St
Norwalk, CT 06850-3852
Phone
(203) 852-2148
Fax
(203) 852-3109
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 003545 CT Primary

Addresses

Primary practice location

24 Stevens St
Norwalk, CT 06850-3852

Mailing address

8 Lowlyn Dr
Westport, CT 06880-1829
Phone (203) 226-0650

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

State licenses

LicenseStateTypeSpecialty
003545CTMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1487858361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LOWLYN DR",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068801829",
            "telephone_number": "203-226-0650",
            "fax_number": "203-852-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 STEVENS ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503852",
            "telephone_number": "203-852-2148",
            "fax_number": "203-852-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWELL",
        "first_name": "MELINDA",
        "middle_name": "ETHEL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CT",
            "license": "003545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.