Individual provider Active NPI

Paula Barracca Novak, RN,MA,CHTP

  • Registered Nurse
  • Norwich, CT
National Provider Identifier
1679752836
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
E34061 Issued in CT
Practice address
326 Washington St
Norwich, CT 06360-2740
Phone
(860) 889-8331
Fax
(860) 885-3562
NPI assigned
Oct 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X E34061 CT Primary

Addresses

Primary practice location

326 Washington St
Norwich, CT 06360-2740

Mailing address

11 Goshen HTS
Lebanon, CT 06249-2405
Phone (860) 642-6428

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
Credentials
Master of Arts, Registered Nurse

State licenses

LicenseStateTypeSpecialty
E34061CTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1679752836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GOSHEN HTS",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "062492405",
            "telephone_number": "860-642-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 WASHINGTON ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602740",
            "telephone_number": "860-889-8331",
            "fax_number": "860-885-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "PAULA",
        "middle_name": "BARRACCA",
        "name_prefix": "Mrs.",
        "credential": "RN,MA,CHTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "E34061",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 24, 2007; 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.