Individual provider Active NPI

Martha Brough, RN

  • Community Health Registered Nurse
  • Woonsocket, RI
National Provider Identifier
1063601136
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN21245 Issued in RI
Practice address
450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
Fax
(401) 235-6899
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN21245 RI Primary
Diabetes Educator Registered Nurse 163WD0400X RN21245 RI

Addresses

Primary practice location

450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207
Phone (401) 767-4100

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN21245RIMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1063601136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "address_2": "THUNDERMIST HEALTH CENTER",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "address_2": "THUNDERMIST HEALTH CENTER",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGH",
        "first_name": "MARTHA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "RI",
            "license": "RN21245",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "RI",
            "license": "RN21245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.