Active NPI
Elizabeth A Gribble, APRN
- Nurse Practitioner
- New Haven, CT
National Provider Identifier
1861640492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 003867
- Practice address
- 226 Dixwell Ave
New Haven, CT 06511-3456 - Phone
- (203) 503-3250
- Fax
- (203) 503-3422
- NPI assigned
- Sep 8, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 003867 | CT | Primary |
Addresses
Primary practice location
226 Dixwell Ave
New Haven, CT 06511-3456
Mailing address
226 Dixwell Ave
New Haven, CT 06511-3456
Phone (203) 503-3250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235900 | Medicaid | CT |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003867 | CT | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1861640492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 DIXWELL AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065113456",
"telephone_number": "203-503-3250",
"fax_number": "203-503-3422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 DIXWELL AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065113456",
"telephone_number": "203-503-3250",
"fax_number": "203-503-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIBBLE",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-08",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "003867",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235900",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.