Active NPI
Cassandra M Wetherby
- Licensed Practical Nurse
- Enfield, CT
National Provider Identifier
1811778657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 044842
- Practice address
- 153 Hazard Ave
Enfield, CT 06082-4592 - Phone
- (860) 731-5522
- Fax
- (860) 731-5536
- NPI assigned
- Oct 9, 2023
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 044842 | CT | Primary |
Addresses
Primary practice location
153 Hazard Ave
Enfield, CT 06082-4592
Mailing address
2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044842 | CT | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1811778657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WATERSIDE XING STE 401",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951588",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 HAZARD AVE",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824592",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETHERBY",
"first_name": "CASSANDRA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-09",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CT",
"license": "044842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.