Active NPI
Ann L Wissink, RNCS
- Adult Psychiatric/Mental Health Registered Nurse
- Cambridge, MA
National Provider Identifier
1215001540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 117810
- Practice address
- 330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502 - Phone
- (617) 499-5054
- Fax
- (617) 499-5465
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 117810 | MA | Primary |
Addresses
Primary practice location
330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Mailing address
One Arsenal Marketplace
Watertown, MA 02472
Phone (617) 673-1851
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00317875 | Other | MA | RAILROAD MEDICARE |
| PN0296 | Other | MA | BLUE CROSS |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215001540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE ARSENAL MARKETPLACE",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "02472",
"telephone_number": "617-673-1851",
"fax_number": "617-499-5579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MOUNT AUBURN ST",
"address_2": "CLARK 1",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385502",
"telephone_number": "617-499-5054",
"fax_number": "617-499-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISSINK",
"first_name": "ANN",
"middle_name": "L",
"credential": "RNCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "MA",
"license": "117810",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00317875",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "PN0296",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.