Individual provider Active NPI

Jason Strickland, APRN

  • Adult Health Nurse Practitioner
  • Bristol, CT
National Provider Identifier
1568552826
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5510 Issued in CT
Practice address
22 Pine St
Suite 104
Bristol, CT 06010-6948
Phone
(860) 584-8291
Fax
(860) 584-8354
NPI assigned
Oct 14, 2006
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 005510 CT
Adult Health Nurse Practitioner 363LA2200X 5510 CT Primary
Family Nurse Practitioner 363LF0000X 5510 CT

Addresses

Primary practice location

22 Pine St
Suite 104
Bristol, CT 06010-6948

Mailing address

22 Pine St
Suite 104
Bristol, CT 06010-6948
Phone (860) 584-8291

Other identifiers 1

IdentifierTypeStateIssuer
1568552826OtherCTANTHEM BCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140522002169 CT Practitioner - Nurse Practitioner 8224251079 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005510CTMDNurse Practitioner
5510CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Nurse Practitioner CurrentSince Nov 15, 2014 Accepting new patients
Prime Healthcare, PC Nurse Practitioner CurrentSince Jul 26, 2016 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Jul 26, 2016 Accepting new patients
MC Diagnostic of Connecticut, P.C. Family CurrentSince Mar 3, 2014 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Nurse Practitioner PastSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC Past Accepting new patients

Locations

22 Pine St
Ste 104
Bristol, CT 06010
Phone (860) 314-2002

3514 Main St
Coventry, CT 06238
Phone (860) 298-5925

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: jstrickland2389361@direct.trinity-health.org

Organizations & group practices 6

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1568552826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 104",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-584-8291",
            "fax_number": "860-584-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 104",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-584-8291",
            "fax_number": "860-584-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRICKLAND",
        "first_name": "JASON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "005510",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "5510",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1568552826",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.