Active NPI
Jacquelyn Marie Moynihan, RN
- Registered Nurse
- Beverly, MA
National Provider Identifier
1144343997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 215615
- Practice address
- 33 Macarthur Rd
Beverly, MA 01915-1629 - Phone
- (978) 921-0745
- NPI assigned
- Apr 9, 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 215615 | MA | Primary |
Addresses
Primary practice location
33 Macarthur Rd
Beverly, MA 01915-1629
Mailing address
25 Rust St
South Hamilton, MA 01982-2222
Phone (978) 468-3622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0704814 | Medicaid | MA |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215615 | MA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1144343997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 RUST ST",
"city": "SOUTH HAMILTON",
"state": "MA",
"postal_code": "019822222",
"telephone_number": "978-468-3622",
"fax_number": "781-944-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 MACARTHUR RD",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019151629",
"telephone_number": "978-921-0745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYNIHAN",
"first_name": "JACQUELYN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "215615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0704814",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.