Active NPI
Mesa Outlaw
- Registered Nurse
- Cambridge, MA
National Provider Identifier
1013508431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 234343
- Practice address
- 1493 Cambridge St
Cambridge, MA 02139-1047 - Phone
- (781) 338-0500
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 234343 | NC | Primary |
Addresses
Primary practice location
1493 Cambridge St
Cambridge, MA 02139-1047
Mailing address
3844 Gloucester Rd
Rocky Mount, NC 27803-1109
Phone (252) 567-7056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234343 | NC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1013508431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3844 GLOUCESTER RD",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278031109",
"telephone_number": "252-567-7056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391047",
"telephone_number": "781-338-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTLAW",
"first_name": "MESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-28",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "234343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.