Individual provider Active NPI

Katherine Thomsen, APRN

  • Adult Health Nurse Practitioner
  • Wethersfield, CT
National Provider Identifier
1659344174
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3038 Issued in CT
Practice address
30 Jordan LN
Wethersfield, CT 06109-1278
Phone
(860) 263-0253
Fax
(860) 263-0262
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3038 CT Primary

Addresses

Primary practice location

30 Jordan LN
Wethersfield, CT 06109-1278

Mailing address

44 Dale Rd
Avon, CT 06001-4320
Phone (860) 674-8830

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
I20040916000815 CT Practitioner - Nurse Practitioner 4486621539 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3038CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Adult Health CurrentSince Sep 9, 2013 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Sep 9, 2013 Accepting new patients

Locations

44 Dale Rd
Avon, CT 06001
Phone (860) 674-8830

893 Main St
Ste 202
East Hartford, CT 06108
Phone (860) 528-4124

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

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, 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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1659344174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014320",
            "telephone_number": "860-674-8830",
            "fax_number": "860-674-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSEN",
        "first_name": "KATHERINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "3038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.