Individual provider Active NPI

Jessica Mullen, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Danbury, CT
National Provider Identifier
1619785391
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
14404 Issued in CT
Practice address
111 Osborne St
Danbury, CT 06810-6000
Phone
(203) 739-7155
NPI assigned
Dec 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 14404 CT Primary

Addresses

Primary practice location

111 Osborne St
Danbury, CT 06810-6000

Mailing address

24 Fulling Mill LN
Ridgefield, CT 06877-3407
Phone (203) 216-8030

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
I20250324001292 CT Practitioner - Nurse Practitioner 5496277014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14404CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Apr 13, 2025 Accepting new patients

Locations

111 Osborne St
Danbury, CT 06810
Phone (203) 739-7131

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1619785391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FULLING MILL LN",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068773407",
            "telephone_number": "203-216-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-26",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "14404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.