Kim Beaudry, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

156137 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(774) 441-6605

NPI assigned

Jan 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hospice of Franklin County, Inc.

  • General Practice Physician
  • Greenfield, MA
  • NPI 1619702784
  NPD
• Hospice of Franklin County, Inc.

  • Community Based Hospice Care Agency
  • Greenfield, MA
  • NPI 1689605859
  NPD

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1083253355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 CONWAY ST",
            "address_2": "STE 2",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013011522",
            "telephone_number": "413-774-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-441-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "KIM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "156137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madjina Beaucejour
• Sarah Beauchemin
• Sarah Marie Beauchemin, PA-C
• John Albert Beauchesne, PAC
• Jennifer Ellen Beaudreau
• Catherine Christina Beauharnais, MD, MPH
• Dennis Kevin Beaulieu
• Meghan L Beaulieu, NNP-BC
• Beaumont at University Campus LLC
• Lindsey Marie Beauregard, RD

• Gerontology Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.