Individual provider Active NPI

Kathryn Jane Gaffney, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Stamford, CT
National Provider Identifier
1700582632
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
8809 Issued in CT
Practice address
45 Church St Apt 3J
Stamford, CT 06906-1760
Phone
(203) 914-5552
NPI assigned
Feb 2, 2023
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 8809 CT Primary

Addresses

Primary practice location

45 Church St Apt 3J
Stamford, CT 06906-1760

Mailing address

45 Church St Apt 3J
Stamford, CT 06906-1760
Phone (203) 914-5552

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
I20251003002537 CT Practitioner - Nurse Practitioner 5991201386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

424 Church St
Nashville, TN 37219-2301

45 Church St
Apt 3J
Stamford, CT 06906-1711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8809CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Sep 1, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1224 Mill St
Bldg B
East Berlin, CT 06023
Phone (860) 406-4894

Organizations & group practices 1

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": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1700582632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CHURCH ST APT 3J",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069061760",
            "telephone_number": "203-914-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CHURCH ST APT 3J",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069061760",
            "telephone_number": "203-914-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAFFNEY",
        "first_name": "KATHRYN",
        "middle_name": "JANE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "8809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.