Active NPI
Michelle F Reardon, NP
- Registered Nurse
- Stamford, CT
National Provider Identifier
1619906054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 063729
- Practice address
- 1039 E Main St
Stamford, CT 06902-4108 - Phone
- (203) 327-2722
- Fax
- (203) 975-4539
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 063729 | CT | Primary |
Addresses
Primary practice location
1039 E Main St
Stamford, CT 06902-4108
Mailing address
345 Whitney Ave
New Haven, CT 06511
Phone (203) 752-2856
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002613 | CT | MD | Mental Health Counselor |
| 063729 | CT | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood of CT, Inc | Past | 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 and National Provider Directory roles.
-
- Ambulatory Family Planning Facility
- Stamford, CT
- NPI 1942338017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1619906054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 WHITNEY AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-752-2856",
"fax_number": "203-752-8785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1039 E MAIN ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069024108",
"telephone_number": "203-327-2722",
"fax_number": "203-975-4539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "MICHELLE",
"middle_name": "F",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "063729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.