Elena Schjavland, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

#002017 Issued in CT

Practice address

20 Burrows St
Keys2Memory, LLC
Mystic, CT 06355-2445

Phone

(860) 245-4144

Fax

(860) 245-4145

NPI assigned

Oct 5, 2006

Last updated

Jan 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Keys2Memory, LLC

  • Gerontology Nurse Practitioner
  • Mystic, CT
  • NPI 1043567647
  Authorized official Same address or phone

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1871689679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 EAST MAIN ST.",
            "address_2": "PO BOX 625",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063550625",
            "telephone_number": "860-908-9799",
            "fax_number": "860-245-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BURROWS ST",
            "address_2": "KEYS2MEMORY, LLC",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552445",
            "telephone_number": "860-245-4144",
            "fax_number": "860-245-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHJAVLAND",
        "first_name": "ELENA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "002017",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "#002017",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "002017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004020178",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey J Ryan, PT
• David Salm, MD
• Daniel Joseph Salvatore, M.S. MFT
• James David Scarles, M.D.
• Jessica Schilke, APRN
• Geoffrey M Schnirman, PHD
• Rachael Maria Schommer, COTA/L
• Lorrain Margaret Schwartz, RPT
• David Schwindt
• Seaport Clinic LLC (Seaport Medical Center)

• Gerontology Nurse Practitioner in Mystic, CT
• Providers in Mystic, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.