IMPACT HEALTH P.C. (NPI# 1730694316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730694316 |
| Entity Type | Organization |
| Organization Name | IMPACT HEALTH P.C. |
| Practice Address |
14 Westport Ave Norwalk CT 06851 |
| Mailing Address |
14 Westport Ave Norwalk CT 06851-3915 |
| Practice Telephone | 0000000000 |
| Mailing Telephone | 0000000000 |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | GARUMUNI A. DESILVA (AUTHORIZED PERSON) |
| Authorized Official Telephone | 2039880766 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | CT | Allopathic & Osteopathic Physicians | |
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Impact Health Psych., PC | 185 Asylum St, Hartford, CT 06103 |
| Street Address |
14 WESTPORT AVE |
| City | NORWALK |
| State | CT |
| Zip Code | 06851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194997791 | Constellation Home Care,llc | Home Health Aide | 14 Westport Ave, Norwalk, CT 06851-3915 | 2008-03-24 |
| 1104432848 | Jessica Mccasland | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2020-09-18 |
| 1396359873 | Melissa Margaret Walker | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2020-09-02 |
| 1114549052 | Emily Kalbfell | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2020-05-14 |
| 1487280699 | Mallory Bevis | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2020-03-19 |
| 1730737867 | Nicole Elizabeth Kaimer | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2019-09-02 |
| 1124689922 | Constellation School Based Therapy, LLC | Community/Behavioral Health | 14 Westport Ave, Norwalk, CT 06851-3915 | 2019-06-24 |
| 1043870801 | Crystal Benson | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2019-06-14 |
| 1215597067 | Amanda Willoughby Doll | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2019-06-14 |
| 1538728548 | Jacqueline Forchetti | Behavioral Analyst | 14 Westport Ave, Norwalk, CT 06851-3915 | 2019-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763434 | Cynthia Eliezer | Student in an Organized Health Care Education/Training Program | 120 East Ave 2nd Flr., Norwalk, CT 06851 | 2016-11-18 |
| 1356897672 | Be Balanced Naturopathic Care Center, LLC | Naturopath | 91 East Ave, Garden Level, Norwalk, CT 06851 | 2016-08-28 |
| 1861843559 | Valerie Andree Vincent | Student in an Organized Health Care Education/Training Program | 120 East Avenue-2nd Floor, Catholic Charities, Norwalk, CT 06851 | 2016-06-24 |
| 1417333758 | Laura Rebecca Nierenberg Fishman | Marriage & Family Therapist | 161 East Avenue, Suite 101, Norwalk, CT 06851 | 2015-08-10 |
| 1487085411 | Danielle Christine Boland | Social Worker | 206 Wolfpit Avenue, Norwalk, CT 06851 | 2013-12-02 |
| 1427485846 | Michelle Clement | Technician/Technologist | 650 Main Avenue, Norwalk, CT 06851 | 2013-09-30 |
| 1932447430 | Rebecca Roessler Velasquez | Social Worker | 225 W Rocks Rd, Norwalk, CT 06851 | 2013-01-18 |
| 1275809154 | Tiffany A. Mccarty | Social Worker | 166 East Ave Ste 204, Norwalk, CT 06851 | 2012-03-26 |
| 1356573547 | Cheree Louise Fenske | Clinical Neuropsychologist | 761 Main Ave Ste 104, Norwalk, CT 06851 | 2009-08-20 |
| 1083869572 | Carol Lynne Cooper | Obstetrics & Gynecology | 17 North Ave., Norwalk, CT 06851 | 2008-11-25 |
| Find all providers in zip 06851 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710498308 | Jodi Lynn Schwab | Nurse Practitioner | 28 Executive Dr Ste C, Norwalk, OH 44857-2480 | 2017-10-23 |
| 1588632665 | Mary A Durand | Nurse Practitioner | 761 Main Ave Ste 201, Norwalk, CT 06851-1080 | 2006-03-14 |
| 1821095613 | Jaclyn Conelius | Nurse Practitioner | 40 Cross St, Norwalk, CT 06851-4647 | 2005-07-07 |
| 1588275424 | Hope Walden | Nurse Practitioner | 34 Maple St, Norwalk, CT 06850-3815 | 2020-08-13 |
| 1487280574 | Shaira Cohen | Nurse Practitioner | 34 Maple St, Norwalk, CT 06850-3815 | 2020-03-20 |
| 1003372442 | Caroline Clara Pinkowish | Nurse Practitioner | 34 Maple St, Norwalk, CT 06850-3894 | 2019-02-11 |
| 1942669569 | Heather Robinson | Nurse Practitioner | 272 Benedict Ave, Norwalk, OH 44857-2374 | 2016-02-11 |
| 1407220858 | Kathleen A Pundy | Nurse Practitioner | 120 Connecticut Ave, Norwalk, CT 06854-1525 | 2015-11-23 |
| 1598916033 | Michelle Rhoda Leonard | Nurse Practitioner | 761 Main Ave, Suite 101, Norwalk, CT 06851-1080 | 2008-10-02 |
| 1598952533 | Sally Anne Royston | Nurse Practitioner | 292 Benedict Ave, Norwalk, OH 44857-2374 | 2007-10-03 |
| Find all providers in NORWALK | ||||
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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.