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INNOVATIVE HEALTHCARE OF CONNECTICUT LLC
NPI 1619567260
Nurse Practitioner - Family in Manchester, CT

Active since January 19, 2021CLIA 07D2220011 · Waiver
112 SPENCER ST STE 2A, MANCHESTER, CT 06040(860) 791-8170(860) 791-8208 Get Directions Write a Review

NPPES record last updated: May 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2025, Jan 19, 2021 (2 updates tracked since 2021).

About Innovative Healthcare Of Connecticut Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE HEALTHCARE OF CONNECTICUT LLC (NPI 1619567260) is a healthcare organization registered as a family in Manchester, Connecticut and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through April 7, 2027 and lists Camylle Appiahene, Nurse Practitioner/owner, as its authorized official.

NPPES Registry Identity

NPI1619567260
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameINNOVATIVE HEALTHCARE OF CONNECTICUT LLC
Location Address112 SPENCER ST STE 2AManchester, CT 06040-4601
Mailing Address112 Spencer St Ste 2aManchester, CT 06040-4601 · (860) 791-8170 · Fax (860) 791-8208
Phone(860) 791-8170
Fax(860) 791-8208
Organization SubpartNo
Authorized OfficialCamylle AppiaheneNurse Practitioner/owner · (860) 985-6259
Enumeration DateJanuary 19, 2021
Last NPPES UpdateMay 23, 20252 updates tracked since enumeration
NPPES CertifiedMay 23, 2025
✔ NPI 1619567260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
112 SPENCER ST STE 2A, Manchester, CT 06040
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2220011

Innovative Healthcare Of Connecticut · Manchester, CT
Active · expires Apr 7, 2027
CLIA Number07D2220011
Laboratory TypePractitioner Other
Certificate Effective DateApril 8, 2025
Certificate Expiration DateApril 7, 2027
Laboratory DirectorCamylle Y. Appiahene
Laboratory Phone(860) 328-6147
Laboratory LocationInnovative Healthcare Of Connecticut112 Spencer Street, Suite 2A, Manchester, CT 06040
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMYLLE APPIAHENE APRN
Nurse Practitioner (Family)
112 SPENCER ST STE 2A
MANCHESTER, CT 06040
Capitol Planning Region (860) 791-8170
DIABETES INSIGHT AND WEIGHT MANAGEMENT
Nurse Practitioner (Family)
112 SPENCER ST STE 2A
MANCHESTER, CT 06040
Capitol Planning Region (959) 301-9075
KATRINA BERISHA
Nurse Practitioner (Family)
112 SPENCER ST STE 2A
MANCHESTER, CT 06040
Capitol Planning Region (860) 791-8170
INTEGRATIVE CORE WELLNESS, LLC
Nurse Practitioner (Primary Care)
112 SPENCER ST STE 2A
MANCHESTER, CT 06040
Capitol Planning Region (860) 797-0163

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Healthcare Of Connecticut LLC's NPI number?

The NPI number for Innovative Healthcare Of Connecticut LLC is 1619567260. It was assigned to this organization in the NPPES registry on January 19, 2021.

Where is Innovative Healthcare Of Connecticut LLC located?

Innovative Healthcare Of Connecticut LLC is located at 112 Spencer St Ste 2A, Manchester, CT 06040. The listed phone number is (860) 791-8170.

What is Innovative Healthcare Of Connecticut LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Innovative Healthcare Of Connecticut LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2220011) is associated with this NPI, valid through April 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Innovative Healthcare Of Connecticut LLC was last updated on May 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.