Active NPI
Ennette S Tawah, MA, MSN,RN
- Registered Nurse
- Worcester, MA
National Provider Identifier
1235420779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN2269766
- Practice address
- 19 Tacoma St
Worcester, MA 01605-3516 - Phone
- (508) 852-1805
- NPI assigned
- May 2, 2011
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2269766 | MA | Primary |
Addresses
Primary practice location
19 Tacoma St
Worcester, MA 01605-3516
Mailing address
39 Belcourt Rd
Worcester, MA 01605-2301
Phone (508) 308-2926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110022061B | Other | MA | GROUP MEDICAID |
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)
- Not enrolled
- Credentials
- Master of Arts, Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2269766 | MA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1235420779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 BELCOURT RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052301",
"telephone_number": "508-308-2926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 TACOMA ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053516",
"telephone_number": "508-852-1805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAWAH",
"first_name": "ENNETTE",
"middle_name": "S",
"credential": "MA, MSN,RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-02",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2269766",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID",
"identifier": "110022061B",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.