CARLY MELISSA MADORE (NPI# 1396012498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396012498 |
| Entity Type | Individual |
| Full Name | CARLY MELISSA MADORE |
| Credential | APRN |
| Practice Address |
248 Flanders Rd Niantic CT 06357-1264 |
| Mailing Address |
32 Plains Rd Haddam CT 06438-1259 |
| Practice Telephone | 8607395426 |
| Mailing Telephone | 8607147420 |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2015-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
004830 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4830 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1396012498 | 05 | |
| CT | MEDICARE- NGS | D400170759 | 01 |
| Street Address |
248 FLANDERS RD |
| City | NIANTIC |
| State | CT |
| Zip Code | 06357-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023094158 | Gina L Williams | Family Medicine | 248 Flanders Rd, Niantic, CT 06357-1264 | 2005-12-20 |
| 1215465703 | Sara Harrington-doyon | Pharmacist | 248 Flanders Rd, Niantic, CT 06357-1264 | 2017-05-26 |
| 1144757543 | David Kenneth Scaramuzzi | Pharmacist | 248 Flanders Rd, Niantic, CT 06357-1264 | 2017-05-16 |
| 1326586041 | Erin Colella | Nurse Practitioner | 248 Flanders Rd, Niantic, CT 06357-1264 | 2017-02-01 |
| 1245662592 | Erica L Lussier | Nurse Practitioner | 248 Flanders Rd, Niantic, CT 06357 | 2013-08-08 |
| 1144400060 | Luanne Benshimol | Nurse Practitioner | 248 Flanders Rd, Niantic, CT 06357-1264 | 2007-11-08 |
| 1336280007 | Neil A Palker | Internal Medicine | 248 Flanders Rd, Niantic, CT 06357-1264 | 2007-02-08 |
| 1518945351 | Brian L Williams | Family Medicine | 248 Flanders Rd, Niantic, CT 06357-1264 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093094401 | Pamela Dhillon | Nurse Practitioner | 215 West Main St, Niantic, CT 06357 | 2011-08-16 |
| 1841454485 | Richard Frederick Jones IIi | Obstetrics & Gynecology | 224 Old Balck Point Rd, Niantic, CT 06357 | 2008-07-14 |
| 1437224771 | Margaret C Barili | Registered Nurse | 369 Main Street, Niantic, CT 06357 | 2006-11-21 |
| 1720163942 | Carole C Olson | Psychologist | 4 N. Pine Street, Ninantic, CT 06357 | 2006-10-26 |
| 1427151513 | Melvin Harold Engel | Family Medicine | 50 Green Cliff Drive, Niantic, CT 06357 | 2006-09-06 |
| 1457304420 | Michele Nadine Litwin | Nurse Practitioner | 30 W Main Street, Niantic, CT 06357 | 2006-05-18 |
| 1487133906 | Ryne Mcmullen | Physical Therapist | 11 Freedom Way Unit B2, Niantic, CT 06357 | 2018-08-07 |
| 1558720854 | Bodhi Naturopathic LLC | Naturopath | 17 Hope Street, Nianic, CT 06357 | 2016-02-15 |
| 1477980480 | Heather Michelle Rynkowski | Physician Assistant | 365 Montauk Ave, Office # 3.525, New London, CT 06357 | 2013-10-04 |
| 1699025965 | Sara B Sherwin | Nurse Practitioner | 248 Flanders Road, Niantic, CT 06357 | 2012-09-14 |
| Find all providers in zip 06357 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245662592 | Erica L Lussier | Nurse Practitioner | 248 Flanders Rd, Niantic, CT 06357 | 2013-08-08 |
| 1699025965 | Sara B Sherwin | Nurse Practitioner | 248 Flanders Road, Niantic, CT 06357 | 2012-09-14 |
| 1255649737 | Juanita Schmitt Durham | Nurse Practitioner | 201 W Main St, Niantic, CT 06357-1014 | 2010-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1023618634 | Jessica Anne Butt | Nurse Practitioner | 93 E Putnam Rd, Putnam, CT 06260-2824 | 2020-11-01 |
| 1962002691 | Marielle Hellerud Khuen | Nurse Practitioner | 39 Fifth St, Norwalk, CT 06855-2402 | 2020-10-30 |
| 1043810013 | Alexa L Carolan | Nurse Practitioner | 24 Penny Ln, Watertown, CT 06795-1734 | 2020-10-29 |
| 1891394219 | Azra Alagic | Nurse Practitioner | 374 Cypress Rd, Newington, CT 06111-5616 | 2020-10-19 |
| 1396352589 | Jeffrey Kiser | Nurse Practitioner | 123 Sisson Ave Fl 3, Hartford, CT 06106-1136 | 2020-09-30 |
| 1932716628 | Tabia Thompson-lamothe | Nurse Practitioner | 16 Woodhill Rd, Trumbull, CT 06611-3356 | 2020-09-26 |
| 1356958243 | Lisa Solari | Nurse Practitioner | 34 Centerwood Rd, Newington, CT 06111-3107 | 2020-09-25 |
| 1558977801 | Megan Bouchard | Nurse Practitioner | 2351 Summer St, Stamford, CT 06905-4504 | 2020-09-22 |
| 1316553233 | Anylen Ruiz Ayala | Nurse Practitioner | 109 W Center St, Manchester, CT 06040-4917 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.