Active NPI
Jessica Chang Lim, F.N.P.
- Family Medicine Physician
- Brockton, MA
National Provider Identifier
1053454272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 258845
- Practice address
- 111 Torrey St
Brockton, MA 02301-4800 - Phone
- (508) 588-1200
- Fax
- (508) 941-0497
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 258845 | MA | Primary |
Addresses
Primary practice location
111 Torrey St
Brockton, MA 02301-4800
Mailing address
111 Torrey St
Brockton, MA 02301-4800
Phone (508) 588-1200
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1053454272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 TORREY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014800",
"telephone_number": "508-588-1200",
"fax_number": "508-941-0497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 TORREY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014800",
"telephone_number": "508-588-1200",
"fax_number": "508-941-0497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "JESSICA",
"middle_name": "CHANG",
"name_prefix": "Miss",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "258845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.