Individual provider Active NPI

Christy Socha, APRN

  • Registered Nurse
  • Norwich, CT
National Provider Identifier
1609849728
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
002932 Issued in CT
Practice address
111 Salem Tpke
Suite 7
Norwich, CT 06360-6459
Phone
(860) 859-2262
NPI assigned
Feb 9, 2006
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 002932 CT
Registered Nurse 163W00000X 002932 CT Primary

Addresses

Primary practice location

111 Salem Tpke
Suite 7
Norwich, CT 06360-6459

Mailing address

111 Salem Tpke
Suite 7
Norwich, CT 06360-6459
Phone (860) 859-2262

Other identifiers 2

IdentifierTypeStateIssuer
400002932CT01OtherCOANTHEM BCBS
P00306351OtherCTRAILROAD

Other names 1

  • Christy Lillibridge Former name

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
I20040803000966 CT Practitioner - Nurse Practitioner 4486625514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology LLCGroup PAC ID 5092706945, 9 clinicians

Practice addresses (Care Compare)

111 Salem Tpke
Suite 7
Norwich, CT 06360-7403
Phone (860) 859-2262

111 Salem Turnpike
Suite 7
Norwich, CT 06360-7403

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002932CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology LLC Registered Nurse CurrentSince Sep 8, 2003 Accepting new patients

Locations

111 Salem Tpke
Ste 7
Norwich, CT 06360
Phone (860) 859-2262

Interoperability endpoints

  • Direct secure messaging: csocha@advdermct.emadirect.md

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1609849728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SALEM TPKE",
            "address_2": "SUITE 7",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063606459",
            "telephone_number": "860-859-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SALEM TPKE",
            "address_2": "SUITE 7",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063606459",
            "telephone_number": "860-859-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCHA",
        "first_name": "CHRISTY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "002932",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "002932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "400002932CT01",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00306351",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "LILLIBRIDGE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.