Individual provider Active NPI

Maribeth Milne, FNP-BC

  • Family Nurse Practitioner
  • Rocky Hill, CT
National Provider Identifier
1689096588
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005449 Issued in CT
Practice address
400 Capital Blvd
Rocky Hill, CT 06067-3576
Phone
(860) 221-0791
NPI assigned
Jan 11, 2014
Last updated
Dec 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 005449 CT Primary

Addresses

Primary practice location

400 Capital Blvd
Rocky Hill, CT 06067-3576

Mailing address

400 Capital Blvd
Rocky Hill, CT 06067-3576
Phone (860) 221-0791

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
I20140527001496 CT Practitioner - Nurse Practitioner 7719100486 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005449CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince Apr 1, 2014 Accepting new patients
Optimus Health Care Inc CurrentSince Apr 1, 2014 Accepting new patients

Locations

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1689096588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "860-221-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "860-221-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILNE",
        "first_name": "MARIBETH",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-11",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

Verify at the official NPI Registry.