Organization Active NPI

Jamii Wellness and Behavioral Medicine, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Boylston, MA
National Provider Identifier
1144853250
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
JAMII WELLNESS AND BEHAVIORAL MEDICINE, LLC
Practice address
360 W Boylston St RM 207
West Boylston, MA 01583-2384
Phone
(978) 821-7288
NPI assigned
Feb 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Authorized official

Name
Mary Beth K. Yentz, DNP, PMHNP-BC, RNNPI 1073097655
Title
Nurse Practitioner
Phone
(978) 821-7288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

360 W Boylston St RM 207
West Boylston, MA 01583-2384

Mailing address

360 W Boylston St RM 207
West Boylston, MA 01583-2384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200424001771 MA Part B Supplier - Clinic/Group Practice 7012347537 Receives reassigned benefits from 2 practitioners
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

360 W Boylston St
Rm 207
West Boylston, MA 01583
Phone (508) 980-5806

255 Park Ave
Ste 704
Worcester, MA 01609

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1144853250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BOYLSTON ST RM 207",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BOYLSTON ST RM 207",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832384",
            "telephone_number": "978-821-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMII WELLNESS AND BEHAVIORAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "YENTZ",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "978-821-7288",
        "authorized_official_credential": "DNP, PMHNP-BC, RN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.