Kemmarie C Beal, APRN
Individual provider Active NPI Nurse Practitioner · Windsor, CT
NPI 1780914374 · NPPES record last updated Sep 9, 2025
Key facts
- NPI
- 1780914374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 004289 (CT)
- Practice address
- 340 Broad St Ste 304
Windsor, CT 06095-3030 - Phone
- (860) 776-0187
- Fax
- (815) 205-4087
- NPI assigned
- Jan 5, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
340 Broad St
Suite 103
Windsor, CT 06095-3030
Phone (860) 776-0187
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120919000005 | CT | Practitioner - Nurse Practitioner | 6800044793 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4289 | CT | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kemmarie Beal, NP, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| University of Connecticut Health Center | Past | Accepting new patients |
Locations
3580 Main St
Ste G
Hartford, CT 06120
Phone (860) 776-0187
340 Broad St
Ste 304
Windsor, CT 06095
Phone (860) 776-0187
340 Broad St
Ste 103
Windsor, CT 06095
Phone (860) 532-5358
Interoperability endpoints
- kbeal10650@direct.med.uchc.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4289 | CT | |
| Nurse Practitioner | 363L00000X | 004289 | CT | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 004289 | CT |
Addresses
Primary practice location
340 Broad St Ste 304
Windsor, CT 06095-3030
Mailing address
340 Broad St Ste 304
Windsor, CT 06095-3030
Phone (860) 776-0187
Other practice location 1
263 Farmington Ave
Farmington, CT 06030-1909
Phone (860) 679-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004289 | Other | CT | LICENSE |
Other providers in Windsor, CT
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- Ashley Beard
- Lashondra Beasley
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- Kara Beaupre
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All providers in Windsor, CT · Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.