Active NPI
Karen Marie Nolan
- Family Nurse Practitioner
- Brockton, MA
National Provider Identifier
1265508196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 146712
- Practice address
- 49 Pearl St
Brockton, MA 02301-2817 - Phone
- (508) 580-1020
- Fax
- (508) 583-6232
- NPI assigned
- Nov 24, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 146712 | MA | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | 146712 | MA |
Addresses
Primary practice location
49 Pearl St
Brockton, MA 02301-2817
Mailing address
150 S Huntington Ave
Boston, MA 02130-4817
Phone (857) 364-5804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110091841A | Medicaid | MA |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146712 | MA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston University Dermatology, Inc. | Past | Accepting new patients | |
| Women'S Health Affiliates, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dermatology Physician
- Boston, MA
- NPI 1376532853
-
- Obstetrics & Gynecology Physician
- Brockton, MA
- NPI 1396783742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1265508196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "857-364-5804",
"fax_number": "857-364-6604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 PEARL ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012817",
"telephone_number": "508-580-1020",
"fax_number": "508-583-6232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "KAREN",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-24",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "146712",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MA",
"license": "146712",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110091841A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.