Individual provider Active NPI

Kathy Volin Pulda, MS, APRN, GNP, BC

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1164521712
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
143746 Issued in MA
Practice address
378 Plantation St
Geriatrics Department
Worcester, MA 01605-2324
Phone
(508) 755-7300
Fax
(508) 755-7395
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 143746 MA Primary

Addresses

Primary practice location

378 Plantation St
Geriatrics Department
Worcester, MA 01605-2324

Mailing address

PO Box 2153 Dept 40338
Birmingham, AL 35287-9386
Phone (706) 271-0100

Other identifiers 1

IdentifierTypeStateIssuer
110090643AMedicaidMA

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
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
143746MAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1164521712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40338",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879386",
            "telephone_number": "706-271-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 PLANTATION ST",
            "address_2": "GERIATRICS DEPARTMENT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052324",
            "telephone_number": "508-755-7300",
            "fax_number": "508-755-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULDA",
        "first_name": "KATHY",
        "middle_name": "VOLIN",
        "credential": "MS, APRN, GNP, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "143746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110090643A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.