Individual provider Active NPI

Clairenette Williams I

  • Health Maintenance Organization
  • New Haven, CT
National Provider Identifier
1740738749
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
HCA.0001178 Issued in CT
Practice address
142 Cedar Hill Ave
Unit 2L
New Haven, CT 06511-2708
Phone
(203) 745-1863
Fax
(203) 498-7670
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X HCA.0001178 CT Primary

Addresses

Primary practice location

142 Cedar Hill Ave
Unit 2L
New Haven, CT 06511-2708

Mailing address

142 Cedar Hill Ave
Unit 2L
New Haven, CT 06511-2708
Phone (203) 745-1863

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

State licenses

LicenseStateTypeSpecialty
HCA.0001178CTMDHealth Maintenance Organization

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1740738749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 CEDAR HILL AVE",
            "address_2": "UNIT 2L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112708",
            "telephone_number": "203-745-1863",
            "fax_number": "203-498-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 CEDAR HILL AVE",
            "address_2": "UNIT 2L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112708",
            "telephone_number": "203-745-1863",
            "fax_number": "203-498-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CLAIRENETTE",
        "name_prefix": "Miss",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CT",
            "license": "HCA.0001178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.