Individual provider Active NPI

Jacquelyn M. Mercey

  • Skilled Nursing Facility
  • Middletown, CT
National Provider Identifier
1922323385
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
001049 Issued in CT
Practice address
4111 Town Brooke
Middletown, CT 06457-6633
Phone
(860) 280-7505
NPI assigned
Mar 29, 2010
Last updated
Mar 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 001049 CT Primary

Addresses

Primary practice location

4111 Town Brooke
Middletown, CT 06457-6633

Mailing address

4111 Town Brooke
Middletown, CT 06457-6633

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

LicenseStateTypeSpecialty
001049CTMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1922323385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 TOWN BROOKE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 TOWN BROOKE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576633",
            "telephone_number": "860-280-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCEY",
        "first_name": "JACQUELYN",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "001049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.