Judith Kathryn Greene

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

002331 Issued in CT

Practice address

225 Hopmeadow St
Suite # 100
Weatogue, CT 06089-9782

Phone

(860) 658-0465

NPI assigned

Oct 4, 2006

Last updated

Aug 30, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Judith Kathryn Gavigan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1861587024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SACHEMS TRL",
            "address_2": "PO BOX 383",
            "city": "WEST SIMSBURY",
            "state": "CT",
            "postal_code": "060922525",
            "telephone_number": "860-651-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HOPMEADOW ST",
            "address_2": "SUITE # 100",
            "city": "WEATOGUE",
            "state": "CT",
            "postal_code": "060899782",
            "telephone_number": "860-658-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JUDITH",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "GAVIGAN",
            "middle_name": "KATHRYN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Fishbein
• Elizabeth J Fisher, OT
• Andrew Ganeles, M.D.
• Steven D Gerber, O.D.
• Devon Gomez
• Sara Grenier, DPT
• Andrew Hanks
• George Hatsian
• Christopher Hayes
• Douglas Michael Hope, DMD

• Pediatric Nurse Practitioner in Weatogue, CT
• Providers in Weatogue, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.