Individual provider Active NPI

Jacalyn Sue Finerty, WHNP-BC

  • Women's Health Nurse Practitioner
  • Providence, RI
National Provider Identifier
1093369936
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APRN02107 Issued in RI
Practice address
101 Dudley St
Providence, RI 02905-2499
Phone
(401) 274-1100
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APRN02107 RI Primary

Addresses

Primary practice location

101 Dudley St
Providence, RI 02905-2499

Mailing address

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1100

Other names 1

  • Jacalyn Sue Friedman Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN02107RIMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1093369936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052499",
            "telephone_number": "401-274-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINERTY",
        "first_name": "JACALYN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "RI",
            "license": "APRN02107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACALYN",
            "last_name": "FRIEDMAN",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.