Individual provider Active NPI

Clelie St Vil, APRN

  • Family Nurse Practitioner
  • Clinton, MA
National Provider Identifier
1053975789
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
266209 Issued in MA
Practice address
792 Main St
Clinton, MA 01510-1608
Phone
(978) 368-7631
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 266209 MA Primary

Addresses

Primary practice location

792 Main St
Clinton, MA 01510-1608

Mailing address

792 Main St
Clinton, MA 01510-1608
Phone (978) 368-7631

Other practice location 1

180 Main St
Andover, MA 01810
Phone (978) 749-4000

Other practice location 2

52 Prospect St
Woburn, MA 01801-4339
Phone (617) 767-1815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210223002778 MA Practitioner - Nurse Practitioner 1658786744 Reassigns benefits to 4 organizations
I20210224001623 ME Practitioner - Nurse Practitioner 1658786744

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence General Community Medical Service PLLCGroup PAC ID 4486941473, 53 clinicians
New England Community Medical Services PLLCGroup PAC ID 8628102928, 53 clinicians

Practice addresses (Care Compare)

290 Littleton Rd
Unit 3
Chelmsford, MA 01824-3429
Phone (978) 685-2460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lme Health Care Inc CurrentSince Aug 3, 2025 Accepting new patients
New England Community Medical Services PLLC CurrentSince Sep 1, 2023 Accepting new patients
Matrix Medical Plus Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients
Lawrence General Community Medical Service PLLC CurrentSince Sep 1, 2023 Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

89 Morton St
Andover, MA 01810
Phone (978) 475-0944

290 Littleton Rd
Unit 3
Chelmsford, MA 01824
Phone (978) 258-4734

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

47 High St
Ste 101
North Andover, MA 01845
Phone (978) 258-4734

966 Park St
Ste B5
Stoughton, MA 02072
Phone (508) 436-3432

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1053975789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 MAIN ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015101608",
            "telephone_number": "978-368-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 MAIN ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015101608",
            "telephone_number": "978-368-7631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Main St",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MA",
            "postal_code": "01810",
            "country_code": "US",
            "telephone_number": "978-749-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "52 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Woburn",
            "state": "MA",
            "postal_code": "018014339",
            "country_code": "US",
            "telephone_number": "617-767-1815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST VIL",
        "first_name": "CLELIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "266209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MA

Sources for this page

Verify at the official NPI Registry.