Individual provider Active NPI

Breann Sara Erickson, RD

  • Registered Dietitian
  • Shelton, CT
National Provider Identifier
1942451893
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
869 Issued in CT
Practice address
2 Trap Falls Rd Ste 100
Shelton, CT 06484-4616
Phone
(203) 926-8835
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 00869 CT
Registered Dietitian 133V00000X 869 CT Primary

Addresses

Primary practice location

2 Trap Falls Rd Ste 100
Shelton, CT 06484-4616

Mailing address

2 Trap Falls Rd Ste 100
Shelton, CT 06484-4616
Phone (203) 926-8835

Other practice location 1

208 Valley Road
New Canaan, CT 06840
Phone (203) 869-5515

Other names 1

  • Breann Farnsworth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000219 CT Practitioner - Registered Dietitian Or Nutrition Professional 3678620150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2 Trap Falls Rd
Suite 100
Shelton, CT 06484-4616
Phone (203) 256-9707

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00869CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Single Specialty CurrentSince Dec 5, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

2660 Main St
Ste 110
Bridgeport, CT 06606
Phone (203) 332-4744

2 Trap Falls Rd
Ste 100
Shelton, CT 06484
Phone (203) 332-4744

2 Trap Falls Rd
Ste 405
Shelton, CT 06484
Phone (203) 929-1954

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 2

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1942451893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD STE 100",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844616",
            "telephone_number": "203-926-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TRAP FALLS RD STE 100",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844616",
            "telephone_number": "203-926-8835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Valley Road",
            "address_purpose": "LOCATION",
            "city": "New Canaan",
            "state": "CT",
            "postal_code": "06840",
            "country_code": "US",
            "telephone_number": "203-869-5515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "BREANN",
        "middle_name": "SARA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "00869",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANN",
            "last_name": "FARNSWORTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.