Individual provider Active NPI

Kara Nelsen, APRN

  • Family Nurse Practitioner
  • South Windsor, CT
National Provider Identifier
1902350382
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6687 Issued in CT
Practice address
925 Sullivan Ave
Suite 1
South Windsor, CT 06074-2025
Phone
(860) 644-1521
NPI assigned
Aug 15, 2016
Last updated
Aug 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6687 CT Primary

Addresses

Primary practice location

925 Sullivan Ave
Suite 1
South Windsor, CT 06074-2025

Mailing address

30 Jordan LN
Wethersfield, CT 06109-1278

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
I20161024000771 CT Practitioner - Nurse Practitioner 9739467978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6687CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Family CurrentSince Sep 6, 2016 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Sep 6, 2016 Accepting new patients
University of Connecticut Student Health and Wellness Past Accepting new patients

Locations

925 Sullivan Ave
Ste 1
South Windsor, CT 06074
Phone (860) 644-1521

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

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, 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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1902350382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SULLIVAN AVE",
            "address_2": "SUITE 1",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742025",
            "telephone_number": "860-644-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN",
        "first_name": "KARA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.