Individual provider Active NPI

Maryjane Chapin O'Malley, RNC, MSN, PNP

  • Community Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1164625125
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
License
172493 Issued in MA
Practice address
253 Summer St
5TH FLR - Cma
Boston, MA 02210-1114
Phone
(888) 897-8947
Fax
(617) 772-5519
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 172493 MA Primary

Addresses

Primary practice location

253 Summer St
5TH FLR - Cma
Boston, MA 02210-1114

Mailing address

100 Baker St
Walpole, MA 02081-4123
Phone (888) 897-8947

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
172493MAMDCommunity Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1164625125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BAKER ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020814123",
            "telephone_number": "888-897-8947",
            "fax_number": "617-772-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 SUMMER ST",
            "address_2": "5TH FLR - CMA",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101114",
            "telephone_number": "888-897-8947",
            "fax_number": "617-772-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "MARYJANE",
        "middle_name": "CHAPIN",
        "credential": "RNC, MSN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MA",
            "license": "172493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.