Individual provider Active NPI

Jeanne Maxwell-Smith

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1053123208
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2380643 Issued in MA
Practice address
399 Congress St Apt 1132
Boston, MA 02210-2583
Phone
(412) 636-1249
NPI assigned
Jan 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2380643 MA Primary

Addresses

Primary practice location

399 Congress St Apt 1132
Boston, MA 02210-2583

Mailing address

399 Congress St Apt 1132
Boston, MA 02210-2583
Phone (412) 636-1249

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

LicenseStateTypeSpecialty
RN2380643MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1053123208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 CONGRESS ST APT 1132",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102583",
            "telephone_number": "412-636-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 CONGRESS ST APT 1132",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102583",
            "telephone_number": "412-636-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL-SMITH",
        "first_name": "JEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2380643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.