Active NPI
Ciara McGovern, AUD
- Audiologist
- Boston, MA
National Provider Identifier
1154048478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4933-SP-AU
- Practice address
- 800 Washington St
Boston, MA 02111-1552 - Phone
- (617) 636-5000
- NPI assigned
- Oct 26, 2022
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4933-SP-AU | MA | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111-1552
Mailing address
800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15747685 | Other | MA | CAQH |
| 4933-SP-AU | Other | MA | MA AUDIOLOGY LICENSE |
| 14440127 | Other | MA | CCC-A; ASHA CERTIFICATION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4933-SP-AU | MA | MD | Audiologist |
| 4933 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1154048478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOVERN",
"first_name": "CIARA",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MA",
"license": "4933-SP-AU",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "15747685",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA AUDIOLOGY LICENSE",
"identifier": "4933-SP-AU",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCC-A; ASHA CERTIFICATION",
"identifier": "14440127",
"state": "MA"
}
],
"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 Nov 17, 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.