Individual provider Active NPI

Terry Ann Holybee, MSN, APRN

  • Family Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1629552211
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7745 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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 7745 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

255 Hempstead St
New London, CT 06320-6204
Phone (860) 443-2896

Other practice location 1

1 Bulkeley Pl
New London, CT 06320-6206
Phone (860) 437-7775 ext. 7333

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
I20190617002236 CT Practitioner - Nurse Practitioner 9830422245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Agency of Southeastern Connecticut, Inc. Past Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. Past Accepting new patients

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1629552211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bulkeley Pl",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063206206",
            "country_code": "US",
            "telephone_number": "860-437-7775 x7333",
            "fax_number": "860-447-2788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLYBEE",
        "first_name": "TERRY",
        "middle_name": "ANN",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.