Individual provider Active NPI

Gabrielle Emmanuel

  • Primary Care Clinic/Center
  • East Hartford, CT
National Provider Identifier
1720818636
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Practice address
87 Church St Ste 206
East Hartford, CT 06108-3742
Phone
(860) 291-9787
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

87 Church St Ste 206
East Hartford, CT 06108-3742

Mailing address

210 Farmington Ave Apt 410
Hartford, CT 06105-3671
Phone (860) 794-7625

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Services, Inc. Primary Care PastSince Aug 11, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1720818636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FARMINGTON AVE APT 410",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053671",
            "telephone_number": "860-794-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 CHURCH ST STE 206",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083742",
            "telephone_number": "860-291-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.