Ketania Marie Charles

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13544 Issued in CT

Practice address

500 Albany Ave
Hartford, CT 06120-2508

Phone

(860) 249-9625

NPI assigned

Jul 31, 2024

Last updated

Oct 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Health Care Management LLCGroup PAC ID 8022497874, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Proactive Health Care Management,LLC

  • Adult Health Nurse Practitioner
  • Milford, CT
  • NPI 1811641145

  Family

  Medicare reassignment Care Compare group NPD
• Careconnectmd Connecticut PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Stamford, CT
  • NPI 1467187336
  Medicare reassignment NPD
• Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
  • NPI 1730284605
  Medicare reassignment NPD
• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740
  Medicare reassignment NPD
• Healthdrive Medical Services Southeast LLC

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1437930146

  CT, Family

  Medicare reassignment NPD
• Value Based Long Term Care H PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Framingham, MA
  • NPI 1134951676

  CT

  Medicare reassignment NPD
• Chronic Care Specialists of NJ PC

  • Internal Medicine Physician
  • Lakewood, NJ
  • NPI 1114817020

  CT

  Medicare reassignment
• Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
  • NPI 1750632659
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729382400000",
    "number": "1528897022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 COLLIER CIR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182002",
            "telephone_number": "347-822-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202508",
            "telephone_number": "860-249-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "KETANIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-10-20",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "13544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Maud Chaplin, M.D.
• Kathleen A Chapman, PHD
• Lana M Chapman, PA-C
• Mavis Chappell, M. ED.
• Alicia Patrice Charles
• Elizabeth Charpentier
• Lydia Ann Charpentier, RN
• Michael Charry, APRN
• Charter Oak Dental Center LLC
• Charter Oak Health Center

• Family Nurse Practitioner in Hartford, CT
• Providers in Hartford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.