Individual provider Active NPI

Meredith Alyssa Poppish, NP

  • Family Nurse Practitioner
  • East Boston, MA
National Provider Identifier
1164410478
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
259053 Issued in MA
Practice address
10 Gove St
East Boston, MA 02128-1920
Phone
(617) 569-5800
Fax
(617) 568-4780
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 259053 MA Primary

Addresses

Primary practice location

10 Gove St
East Boston, MA 02128-1920

Mailing address

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
259053MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1164410478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPISH",
        "first_name": "MEREDITH",
        "middle_name": "ALYSSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "259053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.