JUDY-LYNN SHAFER (NPI# 1396848487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396848487 |
| Entity Type | Individual |
| Full Name | JUDY-LYNN SHAFER |
| Credential | APRN |
| Practice Address |
491 Gold Star Hwy Groton CT 06340 |
| Mailing Address |
1 Wahoo Ave Groton CT 06349-2324 |
| Practice Telephone | 8604455107 |
| Practice Fax Number | 8604481368 |
| Mailing Telephone | 8606942485 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
002332 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004209260 | 05 |
| Street Address |
491 GOLD STAR HWY |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700861689 | Elisa Marie Girard | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340-6206 | 2005-12-13 |
| 1962830281 | Stephanie Olivier | Physician Assistant | 491 Gold Star Hwy, Groton, CT 06340-6226 | 2013-10-23 |
| 1760604961 | Eastern Connecticut Dermatology PC | Specialist | 491 Gold Star Hwy, Suite 310, Groton, CT 06340-6226 | 2007-05-03 |
| 1154478915 | Tricia A. Jacobsen | Obstetrics & Gynecology | 491 Gold Star Hwy, Suite 100, Groton, CT 06340-6226 | 2007-01-04 |
| 1154412674 | Peter T Auerbach | Obstetrics & Gynecology | 491 Gold Star Hwy, Ste 100, Groton, CT 06340 | 2006-09-28 |
| 1972694495 | Michael A Schrempf | Obstetrics & Gynecology | 491 Gold Star Hwy, Suite 100, Groton, CT 06340 | 2006-09-28 |
| 1437167822 | Judith Conkling Fales | Dentist | 491 Gold Star Hwy, Suite 300, Groton, CT 06340-6226 | 2006-08-03 |
| 1497763718 | David Reid Fales | Dentist | 491 Gold Star Hwy, Suite 300, Groton, CT 06340-6226 | 2006-08-03 |
| 1811950074 | Robert B. Ecker | Dermatology | 491 Gold Star Hwy, Suite 310, Groton, CT 06340 | 2006-04-10 |
| 1215908991 | Diane Meg Davidson | Dermatology | 491 Gold Star Hwy, Suite 310, Groton, CT 06340 | 2006-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548655038 | Tania Richard | Nurse Practitioner | 17 Eastwood Rd, Groton, CT 06340-6010 | 2015-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710230842 | Lenore Ann Leone | Nurse Practitioner | 500 Old Farms Rd, Avon, CT 06001-2716 | 2012-10-26 |
| 1669571428 | Mary Jean Walker | Nurse Practitioner | 300 Western Boulevard, Glastonbury, CT 06033 | 2006-09-21 |
| 1992802037 | Adele Silhavy | Nurse Practitioner | 1000 Asylum Ave Rm 1026, Hartford, CT 06105-1701 | 2006-09-20 |
| 1902912827 | Elizabeth Jensen | Nurse Practitioner | 120 Simsbury Rd Ste B, Avon, CT 06001-3735 | 2006-08-22 |
| 1578590485 | Jean E. Mackay | Nurse Practitioner | 67 Hickory Hill Road, Simsbury, CT 06070 | 2006-06-27 |
| 1083687057 | Jeanne Bedard | Nurse Practitioner | 346 Pomfret St, Putnam, CT 06260-1871 | 2006-02-09 |
| 1710963483 | Karen Marie Wunderlich | Nurse Practitioner | 120 Park Lane Rd Ste B202, New Milford, CT 06776-2450 | 2005-12-15 |
| 1467628016 | Jean D Vulte | Nurse Practitioner | 33 Bullet Hill Rd., Bullet Hill Park, Suite 214, Southbury, CT 06488-4699 | 2008-05-05 |
| 1477766202 | Timothy M Barczak Md LLC | Nurse Practitioner | 345 Montauk Ave, New London, CT 06320-4738 | 2007-05-08 |
| 1326166513 | Jean Carol Ohliger | Nurse Practitioner | 1050 Sullivan Ave, Suite A4, South Windsor, CT 06074-2000 | 2007-03-26 |
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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.