Individual provider Active NPI

Emmanuelle A Boco-Bernard, RN

  • Community Health/Public Health Clinical Nurse Specialist
  • Stoughton, MA
National Provider Identifier
1164010211
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health/Public Health Clinical Nurse SpecialistTaxonomy code 364SC1501X
License
RN2338211 Issued in MA
Practice address
86 Daly Dr
Stoughton, MA 02072-3314
Phone
(617) 942-0293
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health/Public Health Clinical Nurse Specialist 364SC1501X RN2338211 MA Primary

Addresses

Primary practice location

86 Daly Dr
Stoughton, MA 02072-3314

Mailing address

415 Columbia Rd
Dorchester, MA 02125-2424
Phone (617) 740-8016

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

LicenseStateTypeSpecialty
RN2338211MAMDCommunity Health/Public Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1164010211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252424",
            "telephone_number": "617-740-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 DALY DR",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723314",
            "telephone_number": "617-942-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCO-BERNARD",
        "first_name": "EMMANUELLE",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC1501X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "MA",
            "license": "RN2338211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.