Individual provider Active NPI

Emily Marton Wiezalis, APRN

  • Family Nurse Practitioner
  • Newington, CT
National Provider Identifier
1558873984
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7323 Issued in CT
Practice address
2288 Berlin Turnpike
2288 Berlin Turnpike
Newington, CT 06111
Phone
(860) 757-3575
NPI assigned
Oct 25, 2017
Last updated
Oct 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7323 CT Primary

Addresses

Primary practice location

2288 Berlin Turnpike
2288 Berlin Turnpike
Newington, CT 06111

Mailing address

312 Georgetown Dr
Glastonbury, CT 06033-2357
Phone (860) 729-2545

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
7323CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Express LLC PastSince Feb 18, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1558873984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 GEORGETOWN DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332357",
            "telephone_number": "860-729-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 BERLIN TURNPIKE",
            "address_2": "2288 BERLIN TURNPIKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-757-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEZALIS",
        "first_name": "EMILY",
        "middle_name": "MARTON",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.