JEREMY TYLER ROCKWELL (NPI# 1952942310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952942310 |
Entity Type | Individual |
Full Name | JEREMY TYLER ROCKWELL |
Credential | APRN |
Practice Address |
320 Pomfret St Putnam CT 06260-1836 |
Practice Telephone | 8609636385 |
Practice Fax Number | 8609636393 |
Mailing Telephone | 8609636385 |
Mailing Fax Number | 8609636393 |
Enumeration Date | 2019-10-07 |
Last Update Date | 2020-06-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
165179 | CT | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
8532 | CT | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1-151908 | AL | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
3504 Vann Rd # 100, Birmingham, AL 352353221 | 2056550585 | 2056550586 |
Street Address |
320 POMFRET ST |
City | PUTNAM |
State | CT |
Zip Code | 06260-1836 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417940271 | Marc B Cerrone | Pediatrics | 320 Pomfret St, Dkh Pediatric Center, Putnam, CT 06260-1836 | 2005-08-26 |
1265065551 | Vanmaly P. Sangasy | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2020-02-15 |
1215588355 | Caitlyn Allyssa Sward | Dietitian, Registered | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-09-20 |
1164082301 | Julie Van Saun | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-06-19 |
1487127171 | Hartford Orthopedic Surgeons,pc | Durable Medical Equipment & Medical Supplies | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-01-07 |
1518434422 | Betsy Alvarado | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2018-10-29 |
1831601848 | Robyn A Martin | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-10-31 |
1922529098 | Raphaella Daggett | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-06-29 |
1770010399 | Gurkirat Singh Sandhu | Internal Medicine | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-05-13 |
1801349931 | Ana Mafalda Andrade Tudela Martins | Pediatrics | 320 Pomfret St, Putnam, CT 06260-1836 | 2016-07-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
Find all providers in zip 06260 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891208039 | Willa M Thompson | Nurse Practitioner | 202 Pomfret St, Putnam, CT 06260-1833 | 2017-11-09 |
1093765232 | Kimberly J Lane | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2006-05-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578164935 | Sheneese Denelle Charles | Nurse Practitioner | 22 Victoria Rd, New Britain, CT 06052-1536 | 2020-11-03 |
1396345179 | Kate Hanselman | Nurse Practitioner | 224 Saint John St # 3l, New Haven, CT 06511-4917 | 2020-10-29 |
1518565399 | Gina Kolstad | Nurse Practitioner | 279 Quarry Rd # 2, Glastonbury, CT 06033-3406 | 2020-10-13 |
1043818966 | Shakeria C Brown | Nurse Practitioner | 567 Millville Ave Apt 3-10, Naugatuck, CT 06770-2337 | 2020-10-13 |
1154937910 | Gregory Guion | Nurse Practitioner | 2275 Silas Deane Highway, 2nd Floor, Rocky Hill, CT 06067-2343 | 2020-09-17 |
1003425331 | Ryan Keenan | Nurse Practitioner | 34 Seaview Ave, West Haven, CT 06516-6846 | 2020-07-22 |
1649888256 | Healthy Minds Pllc | Nurse Practitioner | 40 Russ St, Hartford, CT 06106-1520 | 2020-07-20 |
1174131205 | Kimberly Levitt | Nurse Practitioner | 466 Ridgebury Rd, Ridgefield, CT 06877-1228 | 2020-07-15 |
1801414602 | Georgina Twumasi Mental Health LLC | Nurse Practitioner | 29 Wildwood Cir, South Windsor, CT 06074-1700 | 2020-07-08 |
1356978688 | Rachel Feit | Nurse Practitioner | 63 Pine Tree Dr, Stamford, CT 06906-1529 | 2020-03-25 |
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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.