Marvelle Lisandra Lindo, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

005088 Issued in CT

Practice address

26 Shenipsit Lake Rd
Tolland, CT 06084-2332

Phone

(860) 872-2999

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment NPD
• Innovative Healthcare of Connecticut LLC

  • Family Nurse Practitioner
  • Manchester, CT
  • NPI 1619567260
  NPD (past)
• Urgent Care of Waterbury, LLC

  • Urgent Care Clinic/Center
  • Brookfield, CT
  • NPI 1336519537
  NPD (past)
• WRK Ventures, LLC

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1639427735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 EASTVIEW DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951815",
            "telephone_number": "860-995-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SHENIPSIT LAKE RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060842332",
            "telephone_number": "860-872-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2928 Main St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Glastonbury",
            "state": "CT",
            "postal_code": "060331007",
            "country_code": "US",
            "telephone_number": "860-657-8289",
            "fax_number": "860-657-8291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDO",
        "first_name": "MARVELLE",
        "middle_name": "LISANDRA",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639427735",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime O Lemek, D.C.
• Bethany Ann Lescoe
• Lebert F Lester III, MA
• Saundra Rae Leubner, OTR/L
• Life Long Dental Care of Tolland LLC
• Deborah M. Lines
• Kathleen L Little, LCSW
• Gina Longo
• Geena Lovallo, LMFT
• Theresa C Luddecke, COTA/L

• Family Nurse Practitioner in Tolland, CT
• Providers in Tolland, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.