Individual provider Active NPI

Egenie Desir

  • Registered Nurse
  • Everett, MA
National Provider Identifier
1073060190
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2308132 Issued in MA
Practice address
102 Edith St
Everett, MA 02149
Phone
(781) 691-7130
Fax
(781) 691-7130
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2308132 MA Primary

Addresses

Primary practice location

102 Edith St
Everett, MA 02149

Mailing address

102 Edith St
Everett, MA 02149-1749
Phone (781) 691-7130

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
RN2308132MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1073060190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 EDITH ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021491749",
            "telephone_number": "781-691-7130",
            "fax_number": "781-691-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 EDITH ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "02149",
            "telephone_number": "781-691-7130",
            "fax_number": "781-691-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIR",
        "first_name": "EGENIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2308132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.