Individual provider Active NPI

Kelley Higgins Newlin, APRN

  • Adult Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1518939461
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
002764 Issued in CT
Practice address
1 Shaws CV
Community Health Center Inc.
New London, CT 06320-4902
Phone
(860) 447-8304
Fax
(860) 443-8720
NPI assigned
Feb 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 002764 CT Primary
Primary Care Nurse Practitioner 363LP2300X 002764 CT

Addresses

Primary practice location

1 Shaws CV
Community Health Center Inc.
New London, CT 06320-4902

Mailing address

575 Main St FL 2
Community Health Center Inc.
Middletown, CT 06457-2845
Phone (860) 347-6971

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002764CTMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1518939461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MAIN ST FL 2",
            "address_2": "COMMUNITY HEALTH CENTER INC.",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572845",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHAWS CV",
            "address_2": "COMMUNITY HEALTH CENTER INC.",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204902",
            "telephone_number": "860-447-8304",
            "fax_number": "860-443-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWLIN",
        "first_name": "KELLEY",
        "middle_name": "HIGGINS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-05",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "002764",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "002764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.