Individual provider Active NPI

Mary Poillucci, RNNP

  • Family Nurse Practitioner
  • Framingham, MA
National Provider Identifier
1124544515
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2261419 Issued in MA
Practice address
99 Lincoln St
Framingham, MA 01702-6327
Phone
(508) 875-4811
Fax
(508) 875-5942
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2261419 MA Primary

Addresses

Primary practice location

99 Lincoln St
Framingham, MA 01702-6327

Mailing address

99 Lincoln St
Framingham, MA 01702-6327
Phone (508) 875-4811

Other practice location 1

99 Lincoln St
Framingham, MA 01702-6327
Phone (508) 875-4811

Other names 1

  • Mary Mullins 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

State licenses

LicenseStateTypeSpecialty
RN2261419MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124544515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026327",
            "telephone_number": "508-875-4811",
            "fax_number": "508-875-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026327",
            "telephone_number": "508-875-4811",
            "fax_number": "508-875-5942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026327",
            "country_code": "US",
            "telephone_number": "508-875-4811",
            "fax_number": "508-875-5942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POILLUCCI",
        "first_name": "MARY",
        "credential": "RNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2261419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MULLINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Framingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.