Individual provider Active NPI

Taryn Westfall

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1891316113
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12.008812 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 646-1222
NPI assigned
Apr 27, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.008812 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

512 Spring St
Manchester, CT 06040-6757
Phone (860) 461-6263

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address practicemanager@ctaddictionmedicine.com
Direct Messaging Address slessard@echn.org

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
I20210123000085 CT Practitioner - Nurse Practitioner 9739593203 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Resources, Inc.Group PAC ID 5597652149, 50 clinicians

Practice addresses (Care Compare)

1310 Main St
Willimantic, CT 06226-1910
Phone (860) 456-0038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.008812CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. Multi-Specialty CurrentSince Jan 15, 2021 Accepting new patients
Prospect Manchester Hospital, Inc. Multi-Specialty CurrentSince Nov 8, 2023 Accepting new patients
Eastern Connecticut Medical Professionals Foundation, Inc Multi-Specialty Past Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Multi-Specialty Past Accepting new patients

Locations

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

1310 Main St
Willimantic, CT 06226
Phone (860) 456-0038

2 Waterside Xing
Ste 401
Windsor, CT 06095

Organizations & group practices 5

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1891316113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SPRING ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406757",
            "telephone_number": "860-461-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTFALL",
        "first_name": "TARYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.008812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "practicemanager@ctaddictionmedicine.com",
            "affiliation": "N",
            "address_1": "330 Main St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061061860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slessard@echn.org",
            "affiliation": "N",
            "address_1": "71 Haynes St",
            "city": "Manchester",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060404131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.