Individual provider Active NPI

Gwendolyn Lorraine Watford, R.N.

  • Registered Nurse
  • North Haven, CT
National Provider Identifier
1972963304
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
10.131049 Issued in CT
Practice address
100 State St Apt 139
North Haven, CT 06473-2227
Phone
(860) 729-4711
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10.131049 CT Primary

Addresses

Primary practice location

100 State St Apt 139
North Haven, CT 06473-2227

Mailing address

100 State St Apt 139
North Haven, CT 06473-2227
Phone (860) 729-4711

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
10.131049CTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1972963304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STATE ST APT 139",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732227",
            "telephone_number": "860-729-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STATE ST APT 139",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732227",
            "telephone_number": "860-729-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATFORD",
        "first_name": "GWENDOLYN",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "10.131049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.