Active NPI
Mary D. Lavin, RNP
- Nurse Practitioner
- Jamestown, RI
National Provider Identifier
1285631424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NPP20913
- Practice address
- 20 Southwest Ave
Jamestown, RI 02835-1120 - Phone
- (401) 423-2616
- Fax
- (401) 423-3485
- NPI assigned
- Jul 1, 2005
- Last updated
- Apr 29, 2015
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NPP20913 | RI | Primary |
Addresses
Primary practice location
20 Southwest Ave
Jamestown, RI 02835-1120
Mailing address
117 Ellenfield St
Suite 101
Providence, RI 02905-4513
Phone (401) 444-4318
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23638-6 | Other | RI | RI BC/BS |
| ML42620 | Medicaid | RI | |
| 409407 | Other | RI | RI BLUE CHIP |
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 |
|---|---|---|---|
| NPP20913 | RI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430265600000",
"number": "1285631424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 ELLENFIELD ST",
"address_2": "SUITE 101",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054513",
"telephone_number": "401-444-4318",
"fax_number": "401-444-6573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 SOUTHWEST AVE",
"city": "JAMESTOWN",
"state": "RI",
"postal_code": "028351120",
"telephone_number": "401-423-2616",
"fax_number": "401-423-3485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVIN",
"first_name": "MARY",
"middle_name": "D.",
"credential": "RNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2015-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "RI",
"license": "NPP20913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI BC/BS",
"identifier": "23638-6",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ML42620",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI BLUE CHIP",
"identifier": "409407",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, RI
- Maryanne Guertin, RPH
- Island Therapy, LLC
- Jamestown Home Health Care (Consistent Care CTG Corporation)
- Jamestown School Department
- Jamestown School Department
- Monica Mabe, PH.D., NCSP
- Melissa Ann Mastrostefano, LICSW, CSAC
- Sharon McNeil, COTA/L
- McQuade's Jamestown Pharmacy, LLC (McQuade's Jamestown Pharmacy)
- Michael A Rocchio, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.