Active NPI
Stephanie Athanasoulas Mourtzinos, NP
- Diabetes Educator Registered Nurse
- Lowell, MA
National Provider Identifier
1093868507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 230081
- Practice address
- LCHC
17 Warren Street, 2ND Floor
Lowell, MA 01852 - Phone
- (978) 322-8500
- NPI assigned
- Jan 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 230081 | MA | Primary |
| Family Nurse Practitioner | 363LF0000X | 230081 | MA |
Addresses
Primary practice location
LCHC
17 Warren Street, 2ND Floor
Lowell, MA 01852
Mailing address
LCHC
585 - 597 Merrimack Street
Lowell, MA 01854
Phone (978) 322-8500
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 230081 | MA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1093868507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LCHC",
"address_2": "585 - 597 MERRIMACK STREET",
"city": "LOWELL",
"state": "MA",
"postal_code": "01854",
"telephone_number": "978-322-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LCHC",
"address_2": "17 WARREN STREET, 2ND FLOOR",
"city": "LOWELL",
"state": "MA",
"postal_code": "01852",
"telephone_number": "978-322-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOURTZINOS",
"first_name": "STEPHANIE",
"middle_name": "ATHANASOULAS",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "MA",
"license": "230081",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "230081",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.