Active NPI
Louisa Lea Jellison, RNC, MSN, NNP
- Neonatal Nurse Practitioner
- Boston, MA
National Provider Identifier
1134322936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 115843
- Practice address
- 750 Washington St
Box # 300
Boston, MA 02111-1526 - Phone
- (617) 636-5008
- Fax
- (617) 636-9653
- NPI assigned
- Jun 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 115843 | MA | Primary |
Addresses
Primary practice location
750 Washington St
Box # 300
Boston, MA 02111-1526
Mailing address
15 Carriage LN
Reading, MA 01867-1373
Phone (781) 942-0115
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
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115843 | MA | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134322936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 CARRIAGE LN",
"city": "READING",
"state": "MA",
"postal_code": "018671373",
"telephone_number": "781-942-0115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WASHINGTON ST",
"address_2": "BOX # 300",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111526",
"telephone_number": "617-636-5008",
"fax_number": "617-636-9653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELLISON",
"first_name": "LOUISA",
"middle_name": "LEA",
"name_prefix": "Ms.",
"credential": "RNC, MSN, NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "MA",
"license": "115843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.