Jennifer Lou Landolt, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

7709 Issued in CT

Practice address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534

Phone

(800) 370-3651

Fax

(877) 515-7147

NPI assigned

Jun 18, 2008

Last updated

Aug 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carmel Psychological Health PCGroup PAC ID 4385530351, 222 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cpa.jenniferlandolt@142175.advancedmd-direct.com

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.

• Carmel Psychological Health, PC

  dba LifeStance Psychology

  • Psychologist
  • Carmel, NY
  • NPI 1720194335
  Medicare reassignment Care Compare group
• Damian Family Care Centers, Inc.

  dba Project Samaritan Health Services

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New York, NY
  • NPI 1083093637
  NPD (past)
• Hypnoscope Medical, PC

  • Specialist
  • Carmel, NY
  • NPI 1093024606
  NPD (past)

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1679734123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 E 26TH",
            "address_2": "#3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "646-284-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 8th Ave",
            "address_2": "3rd floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100186504",
            "country_code": "US",
            "telephone_number": "212-904-1500 x244",
            "fax_number": "212-904-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDOLT",
        "first_name": "JENNIFER",
        "middle_name": "LOU",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401083-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "7709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Knight
• Melissa Ann Knowlton, MSPT
• Maria A Koslawy, APRN
• Kathryn G Kozak
• Walter Krauss
• Susan Ferrier Lang
• Patricia Lathrop, RNFA
• Learn
• Amy C Lequire, BCBA
• Brenda L Lewis, OTR

• Psychiatric/Mental Health Nurse Practitioner in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.