Kathleen A Ennis, APRN, DNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

001317 Issued in CT

Practice address

30 Orchard St
Cos Cob, CT 06807-2403

Phone

(203) 253-2225

Fax

(203) 869-4421

NPI assigned

Feb 26, 2007

Last updated

Sep 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Liberation Programs IncGroup PAC ID 8729413604, 11 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Liberation Programs Inc

  • Adult Mental Health Clinic/Center
  • Bridgeport, CT
  • NPI 1316067481
  Medicare reassignment Care Compare group NPD
• Ke Health Services, LLC

  • Adult Mental Health Clinic/Center
  • Bridgeport, CT
  • NPI 1538300678
  NPD (past) Authorized official
• Liberation Programs Inc

  • Adult Mental Health Clinic/Center
  • Stamford, CT
  • NPI 1649390733
  NPD
• Shoreline Psychiatry of Western Connecticut, LLC

  • Psychiatry Physician
  • Norwalk, CT
  • NPI 1134251564
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1750417358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ORCHARD ST",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072403",
            "telephone_number": "203-253-2225",
            "fax_number": "203-869-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ORCHARD ST",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072403",
            "telephone_number": "203-253-2225",
            "fax_number": "203-869-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "APRN, DNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "001317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500000270",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr.Jan Kaplowitz Chiropractic & Wellness Center LLC
• Lisa K Druker, LCSW
• Mira Duncalf, MD
• Ej Lehman Associates PLLC
• Elite Health Services
• Essential Pediatrics Inc.
• Jonathan Filipe, DPT
• Rosa Anna Fini, M.D.
• Morris C Finkelstein, MD
• Trevor M Flouty

• Family Nurse Practitioner in Cos Cob, CT
• Providers in Cos Cob, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.