Individual provider Active NPI

Kira Marie Enloe, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1194426171
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2359040 Issued in MA
Practice address
225 Friend St Ste 800
Boston, MA 02114-1834
Phone
(781) 551-0999
NPI assigned
Mar 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2359040 MA
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2359040 MA Primary

Addresses

Primary practice location

225 Friend St Ste 800
Boston, MA 02114-1834

Mailing address

185 Devonshire St Ste 901
Boston, MA 02110-1485
Phone (781) 551-0999

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
I20240520001420 MA Practitioner - Nurse Practitioner 1850733049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC CurrentSince Apr 13, 2024 Accepting new patients

Locations

225 Friend St
Ste 800
Boston, MA 02114
Phone (617) 936-0488

185 Devonshire St
Ste 801
Boston, MA 02110

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

Organizations & group practices 1

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": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1194426171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 DEVONSHIRE ST STE 901",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101485",
            "telephone_number": "781-551-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 FRIEND ST STE 800",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021141834",
            "telephone_number": "781-551-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOE",
        "first_name": "KIRA",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2359040",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2359040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.