Active NPI
Gene E Landis, NP
- Nurse Practitioner
- Lawrence, MA
National Provider Identifier
1245225671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 104248
- Practice address
- 73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716 - Phone
- (978) 686-3017
- Fax
- (978) 685-4280
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 104248 | MA | Primary |
Addresses
Primary practice location
73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716
Mailing address
73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716
Phone (978) 686-3017
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104248 | MA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362096000000",
"number": "1245225671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73D WINTHROP AVE",
"address_2": "PLAZA 114",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018433716",
"telephone_number": "978-686-3017",
"fax_number": "978-685-4280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73D WINTHROP AVE",
"address_2": "PLAZA 114",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018433716",
"telephone_number": "978-686-3017",
"fax_number": "978-685-4280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDIS",
"first_name": "GENE",
"middle_name": "E",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2013-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "104248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.