Individual provider Active NPI

Grace W. Ndungu, REGISTERED NURSE

  • Registered Nurse
  • Andover, MA
National Provider Identifier
1114356045
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2257940 Issued in MA
Practice address
7 Longwood Dr
Apt. 6
Andover, MA 01810-1570
Phone
(857) 249-7031
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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 2257940 MA Primary

Addresses

Primary practice location

7 Longwood Dr
Apt. 6
Andover, MA 01810-1570

Mailing address

7 Longwood Dr
Apt. 6
Andover, MA 01810-1570
Phone (857) 249-7031

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
2257940MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1114356045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LONGWOOD DR",
            "address_2": "APT. 6",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101570",
            "telephone_number": "857-249-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LONGWOOD DR",
            "address_2": "APT. 6",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101570",
            "telephone_number": "857-249-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUNGU",
        "first_name": "GRACE",
        "middle_name": "W.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2257940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.