Active NPI
Catherine Burns Nyberg, DMD
- General Practice Dentistry
- Norwich, CT
National Provider Identifier
1669419073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6568
- Practice address
- 47 Town St
Norwich, CT 06360-2315 - Phone
- (860) 892-7042
- Fax
- (860) 892-7043
- NPI assigned
- Jun 2, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6568 | CT | Primary |
Addresses
Primary practice location
47 Town St
Norwich, CT 06360-2315
Mailing address
47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002065680 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6568 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1669419073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "860-892-7042",
"fax_number": "860-892-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "860-892-7042",
"fax_number": "860-892-7043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYBERG",
"first_name": "CATHERINE",
"middle_name": "BURNS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-02",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "6568",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002065680",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.