Kerri Helen Anderson, APRN

Individual provider Active NPI Family Nurse Practitioner · East Granby, CT

NPI 1992267660 · NPPES record last updated Apr 2, 2019

Key facts

NPI
1992267660
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
8129 (CT)
Practice address
13 Church Rd
East Granby, CT 06026-9406
Phone
(860) 653-4526
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Granby Family Practice LLC (12 clinicians)
McLean Fund (105 clinicians)

Practice addresses (Care Compare)

13 Church Rd
East Granby, CT 06026-9406
Phone (860) 653-4526

75 Great Pond Rd
Simsbury, CT 06070-1980

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210421001981 CT Practitioner - Nurse Practitioner 0042628596 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
8129CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Granby Family Practice LLC Family Current
since May 1, 2021
Accepting new patients

Locations

13 Church Rd
East Granby, CT 06026
Phone (860) 653-4526

Interoperability endpoints

  • Direct secure messaging: kerri.anderson.1@28841.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8129 CT Yes

Addresses

Primary practice location

13 Church Rd
East Granby, CT 06026-9406

Mailing address

PO Box 194
Canton Center, CT 06020-0194
Phone (860) 810-4295

Other providers in East Granby, CT

All providers in East Granby, CT · Family Nurse Practitioner in Connecticut

Sources for this page

Verify at the official NPI Registry.