Individual provider Active NPI

Stephanie Taylor, APRN

  • Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1669483939
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
000900 Issued in CT
Practice address
300 Summit St
Trinity College Health Center
Hartford, CT 06106-3100
Phone
(860) 297-2018
Fax
(860) 297-2020
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 000900 CT Primary
Registered Nurse 163W00000X 48708 CT

Addresses

Primary practice location

300 Summit St
Trinity College Health Center
Hartford, CT 06106-3100

Mailing address

300 Summit St
Trinity College Health Center
Hartford, CT 06106-3100
Phone (860) 297-2018

Other identifiers 4

IdentifierTypeStateIssuer
2V4069OtherCTHEALTH NET
004238136MedicaidCT
090000OtherCTCONNECTICARE
400000900CT03OtherCTANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48708CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Nurse Practitioner Past Accepting new patients
Shoreline Internal Medicine, LLC PastSince Jan 5, 2009 Accepting new patients
Prohealth Physicians PC Nurse Practitioner Past Accepting new patients
Connecticut Medical Group, LLC Past Accepting new patients

Organizations & group practices 4

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1669483939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SUMMIT ST",
            "address_2": "TRINITY COLLEGE HEALTH CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063100",
            "telephone_number": "860-297-2018",
            "fax_number": "860-297-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SUMMIT ST",
            "address_2": "TRINITY COLLEGE HEALTH CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063100",
            "telephone_number": "860-297-2018",
            "fax_number": "860-297-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "000900",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "48708",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V4069",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004238136",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "090000",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "400000900CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.