Individual provider Active NPI

Pamela Del Pozo-Waldron, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New London, CT
National Provider Identifier
1851565147
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
073430-23 Issued in NH
Practice address
165 State St
New London, CT 06320-6397
Phone
(860) 443-0036
NPI assigned
Apr 17, 2008
Last updated
Mar 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003757 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 073430-23 NH Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 003757 CT

Addresses

Primary practice location

165 State St
New London, CT 06320-6397

Mailing address

165 State St
New London, CT 06320-6397
Phone (860) 443-0036

Other identifiers 1

IdentifierTypeStateIssuer
003757OtherCTCT APRN LICENSE #

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Community Services, Inc. PastSince Apr 25, 2010 Accepting new patients
Associated Specialists of Southeastern Connecticut, Inc. Psychiatric/Mental Health Past Accepting new patients
Urologic Associates, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

Organizations & group practices 3

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1851565147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 STATE ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206397",
            "telephone_number": "860-443-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 STATE ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206397",
            "telephone_number": "860-443-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL POZO-WALDRON",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003757",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "073430-23",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CT",
            "license": "003757",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT APRN LICENSE #",
            "identifier": "003757",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.