Unknown Individual – Nurse Practitioner, NPI 1144396532

Unknown Individual is a healthcare provider. based in Glastonbury, Connecticut. specializing in Nurse Practitioner. They hold a License No. 003312 (CT). The NPI Number for Unknown Individual is 1144396532

Main info

Organization
Inactive
22 Years Of Experience
Name
Unknown Individual
NPI
1144396532
Phone
(860) 916-6244
Address
19 Concord St
Deactivation Date
26 July 2024

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8608861508
Graduation Year
2004 (22 years ago)
PAC ID
8224058698
Group Practice PAC ID
3072683853
Professional Enrollment ID
I20051130000310
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 19 Concord St

    Glastonbury, CT 060332135

    Phone: (860) 916-6244

    Fax: (860) 430-5537

    Type: Location

  • 19, Concord Street, Glastonbury Historic District, Glastonbury, Capitol Planning Region, Connecticut, 06033, United States

    GLASTONBURY, CT 060332135

    Phone: (860) 916-6244

    Type: Mailing

  • 200, West Town Street, Bean Hill Historic District, Norwich, New London County, Connecticut, 06360, United States

    NORWICH, CT 063602112

    Phone: (860) 886-1508

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06033)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072683853View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1144396532 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Glastonbury, Connecticut for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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