Judith Marie Pentedemos, NP

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

201948 Issued in MA

Practice address

200 Groton Rd
Ayer, MA 01432-1168

Phone

(978) 784-9538

Fax

(978) 784-9453

NPI assigned

Feb 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
  • NPI 1417485541
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1245371806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GROTON RD",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321168",
            "telephone_number": "978-784-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GROTON RD",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321168",
            "telephone_number": "978-784-9538",
            "fax_number": "978-784-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTEDEMOS",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MA",
            "license": "201948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "201948",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean J. Overmiller, PHARM.D.
• Bradford Parmenter, LICSW
• Timothy Michael Patno
• Paul L Gunderson, M.D., P.C.
• Paul P. Harasimowicz,III,M.D.,P.C.
• Salvatore Perla, DRPH
• Peter Muz, M.D., P.C.
• Panida Pheang, NP-C
• Primary Care Specialists Inc.
• Stephanie Anne Rempel

• Diabetes Educator Registered Nurse in Ayer, MA
• Providers in Ayer, MA by specialty
• Diabetes Educator Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.