Active NPI
Carol Kagdis, CFNP
- Family Nurse Practitioner
- Fairfield, CT
National Provider Identifier
1558354142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R139553
- Practice address
- 227 Wakeman Rd
Fairfield, CT 06824-5121 - Phone
- (410) 271-9526
- NPI assigned
- Aug 30, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R139553 | MD | Primary |
Addresses
Primary practice location
227 Wakeman Rd
Fairfield, CT 06824-5121
Mailing address
227 Wakeman Rd
Fairfield, CT 06824-5121
Phone (410) 271-9526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6917020 00 | Medicaid | MD |
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: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R139553 | MD | MD | Family Nurse Practitioner |
Interoperability endpoints
- carol.kagdis.1@16244.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261526400000",
"number": "1558354142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 WAKEMAN RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245121",
"telephone_number": "410-271-9526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 WAKEMAN RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245121",
"telephone_number": "410-271-9526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAGDIS",
"first_name": "CAROL",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-30",
"last_updated": "2009-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R139553",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6917020 00",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.