Active NPI
Kristi Maynard, APRN
- Family Nurse Practitioner
- Madison, CT
National Provider Identifier
1821344037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 005023
- Practice address
- 6 Woodland Rd Unit 3B
Madison, CT 06443-2685 - Phone
- (203) 887-3419
- NPI assigned
- Jul 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 005023 | CT | Primary |
Addresses
Primary practice location
6 Woodland Rd Unit 3B
Madison, CT 06443-2685
Mailing address
46 Driscoll Rd
Branford, CT 06405-4534
Phone (203) 887-3419
Other practice location 1
400 W Main St
Branford, CT 06405-3416
Phone (203) 483-7778
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005023 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to Health of Branford, LLC | Family | Current | Accepting new patients |
| Bridgeport Family Medicine LLC | Past | Accepting new patients |
Locations
400 W Main St
Branford, CT 06405
Phone (203) 483-7778
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Bridgeport, CT
- NPI 1548642283
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1821344037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 DRISCOLL RD",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064054534",
"telephone_number": "203-887-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 WOODLAND RD UNIT 3B",
"city": "MADISON",
"state": "CT",
"postal_code": "064432685",
"telephone_number": "203-887-3419"
}
],
"practiceLocations": [
{
"address_1": "400 W Main St",
"address_purpose": "LOCATION",
"city": "Branford",
"state": "CT",
"postal_code": "064053416",
"country_code": "US",
"telephone_number": "203-483-7778",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYNARD",
"first_name": "KRISTI",
"name_prefix": "Dr.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-25",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "005023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.