Individual provider Active NPI

Cecilia Hackerson, APRN

  • Family Nurse Practitioner
  • Meriden, CT
National Provider Identifier
1578295283
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.010703 Issued in CT
Practice address
134 State St
Meriden, CT 06450-3293
Phone
(860) 347-6971
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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 12.010703 CT Primary

Addresses

Primary practice location

134 State St
Meriden, CT 06450-3293

Mailing address

104 Sheldon Ter
New Haven, CT 06511-2008
Phone (413) 230-7664

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
I20240418001535 CT Practitioner - Nurse Practitioner 5991181661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

134 State St
Meriden, CT 06450-3293
Phone (203) 237-2229

19 Grand St
Middletown, CT 06457-2705

675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.010703CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 10, 2024 Accepting new patients
Community Health Center Inc Current Accepting new patients

Locations

134 State St
Meriden, CT 06450
Phone (203) 237-2229

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

85 Lafayette St
New Britain, CT 06051
Phone (860) 224-3642

Interoperability endpoints

  • Direct secure messaging: cecilia.hackerson@chcict.eclinicaldirectplus.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1578295283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SHELDON TER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112008",
            "telephone_number": "413-230-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503293",
            "telephone_number": "860-347-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKERSON",
        "first_name": "CECILIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.010703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.