Individual provider Active NPI

Vanessa Latson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1659998581
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8926 Issued in CT
Practice address
675 Main Street
Middletown, CT 06457
Phone
(860) 347-6971
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 153972 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8926 CT Primary

Addresses

Primary practice location

675 Main Street
Middletown, CT 06457

Mailing address

99 Grove Ave
Wilmington, MA 01887-3720
Phone (617) 922-4442

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
I20240418002699 CT Practitioner - Nurse Practitioner 8426469792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

19 Grand St
Middletown, CT 06457-2705

675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
153972CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 10, 2024 Accepting new patients
Community Health Center Inc Current Accepting new patients
Nutmeg Wellness LLC Psychiatric/Mental Health Past Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

Interoperability endpoints

  • Direct secure messaging: vanessa.latson@chcict.eclinicaldirectplus.com

Organizations & group practices 3

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1659998581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 GROVE AVE",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018873720",
            "telephone_number": "617-922-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MAIN STREET",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-347-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATSON",
        "first_name": "VANESSA",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "153972",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "8926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.