Individual provider Active NPI

Wendy Ann Tagan Conroy, APRN

  • Family Nurse Practitioner
  • Portland, CT
National Provider Identifier
1821119843
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
002581 Issued in CT
Practice address
270 Main St
Portland, CT 06480-1859
Phone
(860) 342-3392
Fax
(860) 358-8658
NPI assigned
Apr 3, 2007
Last updated
Aug 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 002581 CT Primary

Addresses

Primary practice location

270 Main St
Portland, CT 06480-1859

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-4820

Other identifiers 1

IdentifierTypeStateIssuer
008038721MedicaidCT

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

LicenseStateTypeSpecialty
002581CTMDMarriage & Family Therapist
2581CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Chest Physicians, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1821119843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4820",
            "fax_number": "860-358-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801859",
            "telephone_number": "860-342-3392",
            "fax_number": "860-358-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGAN CONROY",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008038721",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.