Individual provider Active NPI

Catherine Nankanja, MSN, SNP

  • Registered Nurse
  • Saugus, MA
National Provider Identifier
1205488830
Registry record updated Jul 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN256774 Issued in MA
Practice address
89 Fairmount Ave
Saugus, MA 01906-1424
Phone
(857) 233-1250
NPI assigned
Jul 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN256774 MA Primary

Addresses

Primary practice location

89 Fairmount Ave
Saugus, MA 01906-1424

Mailing address

89 Fairmount Ave
Saugus, MA 01906-1424
Phone (857) 233-1250

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
I20220405001103 MA Practitioner - Nurse Practitioner 7113313966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN256774MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Health PC CurrentSince Mar 1, 2022 Accepting new patients
Safety Home Health Care Agency PastSince Jul 25, 2019 Accepting new patients

Locations

55 Highland Ave
Ste 304
Salem, MA 01970
Phone (978) 354-4611

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": "1562976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562976000000",
    "number": "1205488830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 FAIRMOUNT AVE",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019061424",
            "telephone_number": "857-233-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 FAIRMOUNT AVE",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019061424",
            "telephone_number": "857-233-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANKANJA",
        "first_name": "CATHERINE",
        "credential": "MSN, SNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-13",
        "last_updated": "2019-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN256774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saugus, MA

Sources for this page

Verify at the official NPI Registry.