Jody Heffernan
Nurse Practitioner (Adult Health)

Address: 111 Goose Ln, Guilford, CT 06437-5101
Phone: 2034582097

Jody Heffernan (NPI# 1043305402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1043305402
Entity Type Individual
Full Name Jody Heffernan
Credential NP
Gender Female
Practice Address 111 Goose Ln
Guilford
CT 06437-5101
Practice Telephone 2034582097
Mailing Address 360 Sea Hill Rd
North Branford
CT 06471-1412
Mailing Telephone 2033151144
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-10-03
Last Update Date 2015-01-27

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers 002918 CT
Yes 363LA2200X Nurse Practitioner · Adult Health Physician Assistants & Advanced Practice Nursing Providers 002918 CT

Other Providers JODY HEFFERNAN

NPI Name Taxonomy Address Enumeration
1336513761 Jody Elizabeth Heffernan Nurse Practitioner 300 Longwood Ave, Nicu - 7 North, Boston, MA 02115-5724 2015-11-23

Physician Overview

NPI 1043305402
PAC ID by PECOS 8820084460
Professional Enrollment ID I20040421000439
Full Name Jody Heffernan
Organization Legal Name YALE UNIVERSITY
Phone Number 2034838300
Gender F
Credential NP
Medical School UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduation Year 2003
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 9436061736
Number of Group Practice Members 1682
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
070022 YALE-NEW HAVEN HOSPITAL

Office Location

Street Address 111 GOOSE LN
City GUILFORD
State CT
Zip Code 06437-5101

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982692794 Thomas E Verdone Specialist 111 Goose Ln, Guilford, CT 06437-5101 2005-10-06
1841462488 Ssc II LLC Clinic/Center 111 Goose Ln, Guilford, CT 06437-5101 2008-03-24
1124299664 Sarah Elizabeth Rogers Physical Therapist 111 Goose Ln, Suite 2500, Guilford, CT 06437-5101 2008-03-12
1861673691 Daniel M Greif Internal Medicine 111 Goose Ln, Guilford, CT 06437-5101 2007-11-20
1477748036 Rebecca Austin Physician Assistant 111 Goose Ln, Shoreline Medical Center-emergency Department, Guilford, CT 06437-5101 2007-09-07
1386836849 Alvin Donald Greenberg Specialist 111 Goose Ln, Ste 2300, Guilford, CT 06437-5101 2007-08-17
1124247325 Cheryl Lea Robaczynski Dietitian, Registered 111 Goose Ln, Ynhh Shoreline Medical Center, Guilford, CT 06437-5101 2007-04-25
1538388350 Susann Caroline Boroczky Dietitian, Registered 111 Goose Ln, Guilford, CT 06437-5101 2007-04-24
1891918850 Yale New Haven Hospital Dietitian, Registered 111 Goose Ln, Office #1806, Guilford, CT 06437-5101 2007-04-10
1871548768 Physiotherapy Associates Inc Clinic/Center 111 Goose Ln, Suite 2500, Guilford, CT 06437-5101 2006-05-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1275012148 Guilford Holistic Health Practitioners, LLC Clinic/Center 5 Durham Rd Ste B6, Guilford, CT 06437 2018-08-10
1912493180 Brianna Renee Hibbard Nurse Practitioner 1057 Boston Post Rd Ste 2, Guilford, CT 06437 2018-07-10
1043738594 Stephanie Rose Weady Physical Therapist 753 Boston Post Road Suite 101, Guilford, CT 06437 2017-09-05
1104221019 Holistic Psychotherapy Social Worker 35 Boston St., Guilford, CT 06437 2014-11-04
1083030332 Frank Edward West Marriage & Family Therapist 17 E. River Rd, Guilford, CT 06437 2014-03-11
1043645856 Kiersten D'auria Marriage & Family Therapist 2651 Boston Post Rd, Guilford, CT 06437 2013-09-11
1063845188 Stephanie Gerrish O'sullivan Health Educator 623 Village Walk, Guilford, CT 06437 2013-08-13
1821364019 Elan Gorshein Internal Medicine Yale-new Haven Shoreline Medical Center, 111 Goose Lane, Suite 1300, Guilford, CT 06437 2012-04-01
1740411396 Denise Lewis Roberts Social Worker 2 Guile Road, Guilford, CT 06437 2009-07-30
1487882437 Bryce E Mcmanus Chiropractor 133 State Street, Guilford, CT 06437 2009-06-29
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952654931 Erica Mcmillian Nurse Practitioner 5 Durham Rd, Building 3, Guilford, CT 06437-2076 2012-10-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1912497751 Catherine Rice Nurse Practitioner 25 Commerce Rd, Newtown, CT 06470-1607 2018-05-17
1194233841 Gayle Jean Roussel Nurse Practitioner 35 Viola Dr, East Hampton, CT 06424-1684 2018-01-16
1013421015 Arlene Elizabeth Butler Nurse Practitioner 1 Hospital Plaza, 3rd Floor - Center Building, Stamford, CT 06904 2017-11-29
1891207411 Michelene Wray Nurse Practitioner 474 Cowperthwaite St Apt C, Danbury, CT 06811-5518 2017-11-05
1366953457 Siobhon Andrews Nurse Practitioner 39 Oxbow Dr, Meriden, CT 06450-6938 2017-10-17
1932624814 Jennifer Chasse Nurse Practitioner 999 Silver Ln Fl 3, Trumbull, CT 06611-5343 2017-08-11
1558882563 Krista Pochron Nurse Practitioner 13 Church St, East Granby, CT 06026-9406 2017-06-29
1699203745 John P Martin-beaulieu Nurse Practitioner 85 Jefferson Street, Hartford Hospital Cardiology Dept, Hartford, CT 06102 2017-06-01
1679012751 Amanda Marie Antonino Nurse Practitioner 197 Fitchville Rd, Apt 5, Bozrah, CT 06334-1135 2017-02-22
1821537085 Lauren Nicole Cerulle Nurse Practitioner 85 Retreat Ave Ste 2, Hartford, CT 06106 2017-02-20
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Competitor

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City GUILFORD
Zip Code 06437

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Dataset Information

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.

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