Individual provider Active NPI

Robert Normandin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Needham, MA
National Provider Identifier
1023524170
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2277952 Issued in MA
Practice address
220 Reservoir St Ste 21
Needham, MA 02494-3133
Phone
(781) 449-1143
NPI assigned
Dec 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2277952 MA
Registered Nurse 163W00000X 069638-21 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2277952 MA Primary

Addresses

Primary practice location

220 Reservoir St Ste 21
Needham, MA 02494-3133

Mailing address

109 Farms Dr
Burlington, MA 01803-3700
Phone (978) 761-3018

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2277952MAMDRegistered Nurse
069638-21NHMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1023524170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FARMS DR",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033700",
            "telephone_number": "978-761-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RESERVOIR ST STE 21",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943133",
            "telephone_number": "781-449-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMANDIN",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2277952",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "069638-21",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2277952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.