Individual provider Active NPI

Kerry Watroba, FNP

  • Family Nurse Practitioner
  • Westford, MA
National Provider Identifier
1184972507
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2263956 Issued in MA
Practice address
174 Littleton Rd
Minuteclinic
Westford, MA 01886-3191
Phone
(978) 692-2111
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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 2263956 MA Primary

Addresses

Primary practice location

174 Littleton Rd
Minuteclinic
Westford, MA 01886-3191

Mailing address

4 Loiselle LN
North Chelmsford, MA 01863-1816
Phone (988) 886-2438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170523001554 MA Practitioner - Nurse Practitioner 7618294950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 788-7344

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22177CAMDOccupational Therapist
2263956MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LGH Medical Group, Inc. CurrentSince Sep 1, 2021 Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

9 Loon Hill Rd
Ste 301
Dracut, MA 01826
Phone (978) 323-0360

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

Interoperability endpoints

  • Direct secure messaging: kwatroba32047@tuftsmedicine.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1184972507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LOISELLE LN",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018631816",
            "telephone_number": "988-886-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 LITTLETON RD",
            "address_2": "MINUTECLINIC",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018863191",
            "telephone_number": "978-692-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATROBA",
        "first_name": "KERRY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2263956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

Verify at the official NPI Registry.