Individual provider Active NPI

Sarah Lynne Fowler

  • Gerontology Nurse Practitioner
  • Waltham, MA
National Provider Identifier
1164574166
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
258694 Issued in MA
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

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
258694MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ajay Anand MD PC PastSince Sep 1, 2010 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.

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.

Verify at the official NPI Registry.