Active NPI
Meghan Dzioba
- Pediatric Nurse Practitioner
- South Windsor, CT
National Provider Identifier
1740863976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 9648
- Practice address
- 2701 Tamarack Ave
South Windsor, CT 06074-5562 - Phone
- (960) 647-8282
- NPI assigned
- May 5, 2021
- Last updated
- May 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 9648 | CT | Primary |
Addresses
Primary practice location
2701 Tamarack Ave
South Windsor, CT 06074-5562
Mailing address
144 Huckleberry LN
Southington, CT 06489-4300
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9648 | CT | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1740863976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 HUCKLEBERRY LN",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064894300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 TAMARACK AVE",
"city": "SOUTH WINDSOR",
"state": "CT",
"postal_code": "060745562",
"telephone_number": "960-647-8282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZIOBA",
"first_name": "MEGHAN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "9648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Windsor, CT
- Vipul Dua, MD
- Maureen Duffy, PT, ATP
- Alyssa Lynn Dugas, APRN
- Latha Dulipsingh, MD
- Jacqueline Duncan, PT
- Eastern Connecticut Medical Professionals Foundation, Inc (Eastern Orthopeadics and Sports Medicine, PC)
- Eastern Connecticut Physician Associates LLC
- Eastern Sports Medicine and Spine Associates LLC
- Echn Wellness Services, Inc. (Women's Center for Wellness)
- Jess Edelstein, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.