Individual provider Active NPI

Cheryl Lyn Murray, PA-C

  • Physician Assistant
  • Farmington, CT
National Provider Identifier
1891726980
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001866 Issued in CT
Practice address
130 Birdseye Rd
Farmington, CT 06032-2444
Phone
(860) 840-7300
Fax
(860) 840-7300
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 001866 CT Primary

Addresses

Primary practice location

130 Birdseye Rd
Farmington, CT 06032-2444

Mailing address

130 Birdseye Rd
Farmington, CT 06032-2444
Phone (860) 840-7300

Other identifiers 2

IdentifierTypeStateIssuer
001866OtherCTLICENSE
C5-0000401OtherDELICENSE

Other names 1

  • Cheryl Lyn Heintzelman Former name

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001866CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc Physician Assistant Past Accepting new patients
Trinity Health of New England Provider Network Organization Inc Past Accepting new patients
Connecticut Hand and Orthopedics PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1891726980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BIRDSEYE RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322444",
            "telephone_number": "860-840-7300",
            "fax_number": "860-840-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BIRDSEYE RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322444",
            "telephone_number": "860-840-7300",
            "fax_number": "860-840-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "CHERYL",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "001866",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "C5-0000401",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "HEINTZELMAN",
            "middle_name": "LYN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.