Individual provider Active NPI

Nicole Rice, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1205546223
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
076588-23 Issued in NH
Practice address
30 Meadowbrook Rd
Brockton, MA 02301-7122
Phone
(508) 584-9210
NPI assigned
Nov 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 076588-21 NH
General Practice Registered Nurse 163WG0000X RN2320001 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2320001 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 076588-23 NH Primary

Addresses

Primary practice location

30 Meadowbrook Rd
Brockton, MA 02301-7122

Mailing address

PO Box 638
Bryantville, MA 02327-0638
Phone (508) 942-7776

Other practice location 1

61 Industrial Park Rd
Plymouth, MA 02360-7246
Phone (508) 830-1234

Other practice location 2

108 N Front St
New Bedford, MA 02740-7327
Phone (774) 628-1000

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
I20231108000776 MA Practitioner - Nurse Practitioner 3173998580 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
076588-21NHMDGeneral Practice Registered Nurse

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": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1205546223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "BRYANTVILLE",
            "state": "MA",
            "postal_code": "023270638",
            "telephone_number": "508-942-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-584-9210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Industrial Park Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023607246",
            "country_code": "US",
            "telephone_number": "508-830-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 N Front St",
            "address_purpose": "LOCATION",
            "city": "New Bedford",
            "state": "MA",
            "postal_code": "027407327",
            "country_code": "US",
            "telephone_number": "774-628-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICE",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NH",
            "license": "076588-21",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "RN2320001",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2320001",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "076588-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.