NPIMap

Organization Active NPI

Professional Nurse Practitioner

  • Psychiatry Physician
  • Newington, CT
National Provider Identifier
1710605845
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PROFESSIONAL NURSE PRACTITIONER
Practice address
127 Hampton CT
Newington, CT 06111-1144
Phone
(860) 983-9965
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Marisol Rodriguez, APRNNPI 1700125804
Title
Owner
Phone
(475) 302-6667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

127 Hampton CT
Newington, CT 06111-1144

Mailing address

127 Hampton CT
Newington, CT 06111-1144
Phone (860) 983-9965

Other names 1

  • Marisol Rodriguez Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL marisol@professionalnursepractitioner.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1710605845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HAMPTON CT",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061111144",
            "telephone_number": "860-983-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 HAMPTON CT",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061111144",
            "telephone_number": "860-983-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL NURSE PRACTITIONER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MARISOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "475-302-6667",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "marisol@professionalnursepractitioner.com",
            "affiliation": "N",
            "address_1": "127 Hampton Ct",
            "city": "Newington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061111144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marisol Rodriguez",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.