Active NPI
Ketta Pierre Germain, RN
- Adult Psychiatric/Mental Health Registered Nurse
- Brockton, MA
National Provider Identifier
1083378269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- RN2262346
- Practice address
- 51 Poole St
Brockton, MA 02301-1803 - Phone
- (617) 818-4751
- NPI assigned
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | RN2262346 | MA | Primary |
Addresses
Primary practice location
51 Poole St
Brockton, MA 02301-1803
Mailing address
51 Poole St
Brockton, MA 02301-1803
Phone (617) 818-4751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590707780 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN2262346 | MA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1083378269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 POOLE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011803",
"telephone_number": "617-818-4751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 POOLE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011803",
"telephone_number": "617-818-4751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERRE GERMAIN",
"first_name": "KETTA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "MA",
"license": "RN2262346",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "590707780",
"state": "MA"
}
],
"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 Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.