Active NPI
Sarah Lynne Fowler
- Gerontology Nurse Practitioner
- Waltham, MA
National Provider Identifier
1164574166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 258694
- Practice address
- 950 Winter St
Suite 3800
Waltham, MA 02451-1424 - Phone
- (781) 472-8604
- NPI assigned
- Jan 18, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 258694 | MA | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 258694 | MA |
Addresses
Primary practice location
950 Winter St
Suite 3800
Waltham, MA 02451-1424
Mailing address
56 Keslar Ave
Lynn, MA 01905-1414
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 |
|---|---|---|---|
| 258694 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ajay Anand MD PC | Past | Accepting new patients | |
| Ajay Anand MD PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nursing Facility/Intermediate Care Facility
- Weston, MA
- NPI 1376093260
-
- Internal Medicine Physician
- Weston, MA
- NPI 1558403154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1164574166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 KESLAR AVE",
"city": "LYNN",
"state": "MA",
"postal_code": "019051414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 WINTER ST",
"address_2": "SUITE 3800",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511424",
"telephone_number": "781-472-8604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "SARAH",
"middle_name": "LYNNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MA",
"license": "258694",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "258694",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.