Active NPI
Maria Mauldon, APRN
- Community Health Nurse Practitioner
- New Haven, CT
National Provider Identifier
1750485801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Nurse Practitioner
- License
- 000435
- Practice address
- 374 Grand Ave
Fair Haven Community Health Ctr
New Haven, CT 06511 - Phone
- (203) 777-7411
- Fax
- (203) 777-8506
- NPI assigned
- Sep 11, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Community Health Nurse Practitioner | 363LC1500X | 000435 | CT | Primary |
Addresses
Primary practice location
374 Grand Ave
Fair Haven Community Health Ctr
New Haven, CT 06511
Mailing address
1976 Chapel St
New Haven, CT 06515
Phone (203) 387-7537
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235736 | Medicaid | CT | |
| 0004359734 | Other | CTCXRE | |
| 400000435CT | Other | ANTHEM BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000435 | CT | MD | Athletic Trainer |
Interoperability endpoints
- mmauldon38345@direct.ynhh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750485801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1976 CHAPEL ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06515",
"telephone_number": "203-387-7537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 GRAND AVE",
"address_2": "FAIR HAVEN COMMUNITY HEALTH CTR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-777-7411",
"fax_number": "203-777-8506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAULDON",
"first_name": "MARIA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": "CT",
"license": "000435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235736",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CTCXRE",
"identifier": "0004359734",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "400000435CT",
"state": null
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.