Active NPI
Katherine Tracy Munn, PH.D.
- Psychologist
- Somerville, MA
National Provider Identifier
1295875011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6007
- Practice address
- 1 Fitchburg St
#C410
Somerville, MA 02143-2136 - Phone
- (617) 764-1886
- NPI assigned
- Feb 8, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6007 | MA | Primary |
Addresses
Primary practice location
1 Fitchburg St
#C410
Somerville, MA 02143-2136
Mailing address
1 Fitchburg St
#C410
Somerville, MA 02143-2136
Phone (617) 764-1886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W04826 | Other | MA | BCBSMA PROVIDER ID |
Other names 1
- Dr. K. Tracy Munn
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6007 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295875011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FITCHBURG ST",
"address_2": "#C410",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021432136",
"telephone_number": "617-764-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 FITCHBURG ST",
"address_2": "#C410",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021432136",
"telephone_number": "617-764-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNN",
"first_name": "KATHERINE",
"middle_name": "TRACY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6007",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA PROVIDER ID",
"identifier": "W04826",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "K.",
"last_name": "MUNN",
"middle_name": "TRACY",
"prefix": "DR.",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Somerville, 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.