Individual provider Active NPI

Cynthia M Grindle, APRN

  • Family Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1982682092
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
002750 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 533-6595
Fax
(860) 533-6594
NPI assigned
Jan 9, 2006
Last updated
May 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18495 SC
Family Nurse Practitioner 363LF0000X 192059 MA
Family Nurse Practitioner 363LF0000X 002750 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 533-6595

Other practice location 1

3 Richland Medical Park Dr Ste 120
Columbia, SC 29203-6850
Phone (803) 434-8866

Other identifiers 2

IdentifierTypeStateIssuer
1609855162MedicaidCT
004247806MedicaidCT

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
I20031215000715 CT Practitioner - Nurse Practitioner 5991602336 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002750CTMDClinical Child & Adolescent Psychologist
18495SCMDSocial Worker
2750CTMDRegistered Dietitian
192059MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Urgent Care Centers, LLC CurrentSince Apr 16, 2018 Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Sound Physicians of Massachusetts II PC CurrentSince Apr 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Connecticut, LLC CurrentSince Oct 28, 2019 Accepting new patients
Doctordoctors LLC Past Accepting new patients
Antero Urgent Care LLC PastSince Aug 23, 2020 Accepting new patients
Johnson Professional Associates, PC Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

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

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1982682092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-533-6595",
            "fax_number": "860-533-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-533-6595",
            "fax_number": "860-533-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Richland Medical Park Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036850",
            "country_code": "US",
            "telephone_number": "803-434-8866",
            "fax_number": "803-933-3049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRINDLE",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18495",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "192059",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609855162",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004247806",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.