John Wright, PMHNP

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

12622 Issued in CT

Practice address

420 N Main St
Bristol, CT 06010-4923

Phone

(860) 583-5858

NPI assigned

Nov 17, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bristol Hospital Incorporated

  • General Acute Care Hospital
  • Bristol, CT
  • NPI 1619901642
  Medicare reassignment NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1720853989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PEACH TREE LN",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060103016",
            "telephone_number": "860-995-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104923",
            "telephone_number": "860-583-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JOHN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Wiseman, RN/STUDENT FNP
• Robert Albert Wollenberg, RPH
• Marlena Wollman, RDH
• Lavonne Womack, LCSW
• Shue Wong, MD
• Christine Xanthoudakis
• Carolyn Michelle Yagaloff, LMFT
• Jared Yager, LAT, ATC
• Samir Aziz Yaseen
• James Yi

• Psychiatric/Mental Health Clinical Nurse Specialist in Bristol, CT
• Providers in Bristol, CT by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.