Active NPI
Gail Beaven Wangerin, PHD RN CS
- Clinical Nurse Specialist
- Lawrence, MA
National Provider Identifier
1265554125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 88312
- Practice address
- 599 Canal St
5TH Floor East
Lawrence, MA 01840 - Phone
- (978) 682-8881
- Fax
- (978) 682-8872
- NPI assigned
- Apr 4, 2007
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 88312 | MA | Primary |
Addresses
Primary practice location
599 Canal St
5TH Floor East
Lawrence, MA 01840
Mailing address
599 Canal St
5TH Floor East
Lawrence, MA 01840
Phone (978) 682-8881
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000037939 | Other | HEALTH NET | |
| PN0147 | Other | BLUE CROSS | |
| 002253 | Other | HARVARD | |
| 1858088 | Medicaid | MA | |
| 1898434 | Medicaid | MA | |
| 1034440 | Other | NHP |
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
- Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88312 | MA | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265554125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "599 CANAL ST",
"address_2": "5TH FLOOR EAST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "01840",
"telephone_number": "978-682-8881",
"fax_number": "978-682-8872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "599 CANAL ST",
"address_2": "5TH FLOOR EAST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "01840",
"telephone_number": "978-682-8881",
"fax_number": "978-682-8872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGERIN",
"first_name": "GAIL",
"middle_name": "BEAVEN",
"credential": "PHD RN CS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "MA",
"license": "88312",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "000000037939",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "PN0147",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD",
"identifier": "002253",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1858088",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1898434",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1034440",
"state": null
}
],
"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 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.