Individual provider Active NPI

Keri Murray

  • Nurse Practitioner
  • Enfield, CT
National Provider Identifier
1851302780
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
003366 Issued in CT
Practice address
875 Enfield St
Enfield, CT 06082-3617
Phone
(866) 389-2727
NPI assigned
Aug 9, 2006
Last updated
Feb 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 003366 CT Primary

Addresses

Primary practice location

875 Enfield St
Enfield, CT 06082-3617

Mailing address

875 Enfield St
Enfield, CT 06082-3617
Phone (866) 389-2727

Other practice location 1

875 Enfield St
Enfield, CT 06082-3617
Phone (186) 638-9272

Other identifiers 4

IdentifierTypeStateIssuer
030366OtherCTCONNECTICARE
400003366CT01OtherCTANTHEM
004259124MedicaidCT
2V7309OtherCTHEALTH NET

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060410000086 CT Practitioner - Nurse Practitioner 3678582343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Diagnostic of Connecticut, P.C.Group PAC ID 0941382113, 66 clinicians

Practice addresses (Care Compare)

875 Enfield St
Enfield, CT 06082-3617
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003366CTMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MC Diagnostic of Connecticut, P.C. CurrentSince Mar 31, 2007 Accepting new patients
Minuteclinic Primary Care Connecticut PLLC CurrentSince Jun 4, 2025 Accepting new patients

Locations

3514 Main St
Coventry, CT 06238
Phone (860) 298-5925

875 Enfield St
Enfield, CT 06082
Phone (860) 741-3013

323 Cromwell Ave
Rocky Hill, CT 06067
Phone (860) 384-9666

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1851302780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823617",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823617",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Enfield St",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060823617",
            "country_code": "US",
            "telephone_number": "186-638-9272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "KERI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "003366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "030366",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "400003366CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004259124",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V7309",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.