Audrey M Kemp (NPI# 1407370976, PAC ID# 6204109325) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1407370976 |
| PAC ID by PECOS | 6204109325 |
| Professional Enrollment ID | I20170912000043 |
| Full Name | Audrey M Kemp |
| Organization Legal Name | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Address |
26 Shenipsh Lake Rd Tolland CT 06084-2332 |
| Phone Number | 8608722999 |
| Gender | F |
| Medical School | UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7416244496 |
| Number of Group Practice Members | 261 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070012 | ROCKVILLE GENERAL HOSPITAL |
| 070027 | MANCHESTER MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 | 8608722999 | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Organization Legal Name | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Physicians | 222 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eyone Jones | General Surgery | Prospect Ct Medical Foundation, Inc. | 18 Haynes St, Uppr Level, Manchester, CT 06040-4111 |
| Isaac Okyere Ampofo | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 629 Middle Tpke E, Manchester, CT 06040-3731 |
| Kelli A Harper | Family Medicine | Prospect Ct Medical Foundation, Inc. | 175 W Rd, Ellington, CT 06029-3730 |
| Marcy A Calsetta | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 520 Hartford Tpke, Suite M, Vernon, CT 06066-5044 |
| Michele P Barry | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 145 Union St, Vernon Rockville, CT 06066-3025 |
| Khadijat O Balogun | Gastroenterology | Prospect Ct Medical Foundation, Inc. | 353 Main St, Manchester, CT 06040-4145 |
| Juan Diego Holguin | General Surgery | Prospect Ct Medical Foundation, Inc. | 1625 Straits Tpke, Suite 200, Middlebury, CT 06762-1836 |
| Michael D Waddington | Neurology | Prospect Ct Medical Foundation, Inc. | 29 Haynes St, Suite D, Manchester, CT 06040-4139 |
| Wendy S Garvin | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 |
| Charles A Mandelberg | Family Medicine | Prospect Ct Medical Foundation, Inc. | 28 Main St, East Hartford, CT 06118-3243 |
| Street Address |
26 SHENIPSH LAKE RD |
| City | TOLLAND |
| State | CT |
| Zip | 06084-2332 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wendy S Garvin | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 |
| Katlin Luu | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 |
| Marvelle L Lindo | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Jane Backus | Psychologist, Clinical | 129 Tolland Stage Rd, Suite 1, Tolland, CT 06084-2343 | |
| Victoria Guglielmone | Clinical Social Worker | Connected Counseling LLC | 14 Pinegrove Dr, Tolland, CT 06084-2603 |
| Guy W Gottier | Chiropractic | Westside Chiropractic of Tolland, LLC | 68 Hartford Tpke, Tolland, CT 06084-2866 |
| Christopher C Prewo | Chiropractic | Westside Chiropractic of Tolland, LLC | 68 Hartford Tpke, Tolland, CT 06084-2866 |
| Erin A Shepherd | Chiropractic | Westside Chiropractic of Tolland, LLC | 68 Hartford Tpke, Tolland, CT 06084-2866 |
| Marian L Vitali | Chiropractic | Westside Chiropractic of Tolland, LLC | 68 Hartford Tpke, Tolland, CT 06084-2866 |
| Edward S Sawicki | Internal Medicine | Med East Associates LLC | 200 Merrow Rd, Tolland, CT 06084-3416 |
| Jaime O Lemek | Chiropractic | 200 Merrow Rd, Unit K, Tolland, CT 06084-3416 | |
| Richard P Dibala | Family Medicine | Med East Associates LLC | 200 Merrow Rd, Tolland, CT 06084-3416 |
| Eric A Levine | Podiatry | 200 Merrow Rd, Tolland, CT 06084-3416 | |
| Find all physicians in zip 06084 | |||
| City | TOLLAND |
| Zip Code | 06084 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | TOLLAND + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.