Individual provider Active NPI

Amy Smith, APRN

  • Family Nurse Practitioner
  • Prospect, CT
National Provider Identifier
1750617817
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4693 Issued in CT
Practice address
8 Timber Hill Rd
Prospect, CT 06712-1348
Phone
(203) 980-9807
NPI assigned
Oct 26, 2009
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4693 CT Primary

Addresses

Primary practice location

8 Timber Hill Rd
Prospect, CT 06712-1348

Mailing address

8 Timber Hill Rd
Prospect, CT 06712-1348
Phone (039) 809-8072

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110926000487 CT Practitioner - Nurse Practitioner 5698946556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

690 Main St S
Southbury, CT 06488-2217
Phone (203) 264-6503

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4693CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven L. Saunders, M.D., LLC CurrentSince Mar 31, 2022 Accepting new patients
Prohealth Physicians PC Family CurrentSince Jan 9, 2023 Accepting new patients
Mark a. Perrotti,M.D.LLC CurrentSince Sep 10, 2023 Accepting new patients

Locations

251 W Main St
Branford, CT 06405
Phone (203) 315-5300

251 W Main St
Ste 5
Branford, CT 06405
Phone (203) 481-0077

849 Boston Post Rd
Ste 102
Milford, CT 06460
Phone (203) 867-6848

Interoperability endpoints

  • Direct secure messaging: amy.smith.1@8514.direct.athenahealth.com
  • Direct secure messaging: amysmith@mperrotti.directglo.com
  • FHIR API: https://api.platform.athenahealth.com/8514/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1750617817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TIMBER HILL RD",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121348",
            "telephone_number": "039-809-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TIMBER HILL RD",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121348",
            "telephone_number": "203-980-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "4693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prospect, CT

Sources for this page

Verify at the official NPI Registry.