Individual provider Active NPI

Martha Burke O'Brien, APRN

  • Adult Health Nurse Practitioner
  • Wethersfield, CT
National Provider Identifier
1770566689
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
001039 Issued in CT
Practice address
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone
(860) 944-4366
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X E52807 CT
Adult Health Nurse Practitioner 363LA2200X 001039 CT Primary

Addresses

Primary practice location

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337

Mailing address

36 Folly Brook LN
Manchester, CT 06040-7079
Phone (860) 944-4366

Other practice location 1

36 Folly Brook Ln
Manchester, CT 06040-7079
Phone (860) 944-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001039CTMDAddiction (Substance Use Disorder) Counselor
E52807CTMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: martha.o'brien@xdr.hhchealthdirect.org
  • Direct secure messaging: mobrien280353@xdr.hhchealthdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1770566689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 FOLLY BROOK LN",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060407079",
            "telephone_number": "860-944-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-944-4366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Folly Brook Ln",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060407079",
            "country_code": "US",
            "telephone_number": "860-944-4366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARTHA",
        "middle_name": "BURKE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "E52807",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "001039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.