CAROLYN FETCHEL – Family Nurse Practitioner, NPI 1396539680

CAROLYN FETCHEL is a healthcare provider. based in Durham, Connecticut. specializing in NURSE PRACTITIONER. They hold a License No. 12.013729 (CT). The NPI Number for CAROLYN FETCHEL is 1396539680

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
CAROLYN FETCHEL
NPI
1396539680
Phone
Not provided
Address
25 GREEN LN
Enumeration Date
9 April 2025
Last Update Date
21 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2038104151
Graduation Year
2024 (2 years ago)
PAC ID
0941798573
Group Practice PAC ID
9032147509
Professional Enrollment ID
I20251024000544
Address ID
CT068306080GR600XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

4,191 NURSE PRACTITIONER in CT

Provider Addresses for CAROLYN FETCHEL

  • 25 GREEN LN

    DURHAM, CT 064221904

    Phone:

    Type: Mailing

  • 600 W PUTNAM AVE

    GREENWICH, CT 068306080

    Phone: (203) 413-0630

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251024000544INurse PractitionerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 06422)

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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: 9032147509View full group profile
NameSpecialtyState
Physician AssistantCT
D E R M A T O L O G YCT
Nurse PractitionerCT
Physician AssistantCT
D E R M A T O L O G YNY
-CT
-TX
Physician AssistantNY
Physician AssistantCT
Nurse PractitionerCT

Reviews

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Frequently asked questions

What unique ID ties claims to CAROLYN FETCHEL?
NPI 1396539680 is assigned to CAROLYN FETCHEL under the national enumeration system.
Is CAROLYN FETCHEL's NPI currently valid?
The extract we use shows CAROLYN FETCHEL as active.
Can you summarize CAROLYN FETCHEL's specialty in plain language?
Clinically, the directory lists CAROLYN FETCHEL with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for CAROLYN FETCHEL?
We surface Durham, Connecticut for CAROLYN FETCHEL based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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