Individual provider Active NPI

Maria Louise McGurrin

  • Pediatric Nurse Practitioner
  • East Providence, RI
National Provider Identifier
1306422779
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN03606 Issued in RI
Practice address
36 Captain John Jacobs Rd Apt 208
East Providence, RI 02914-5372
Phone
(617) 449-8309
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2337727 MA
Pediatric Nurse Practitioner 363LP0200X 95019233 CA
Pediatric Nurse Practitioner 363LP0200X APRN03606 RI Primary

Addresses

Primary practice location

36 Captain John Jacobs Rd Apt 208
East Providence, RI 02914-5372

Mailing address

36 Captain John Jacobs Road
Unit 208
East Providence, RI 02914-3329
Phone (617) 449-8309

Other identifiers 2

IdentifierTypeStateIssuer
RN2337727OtherMARN LICENCE NUMBER
APRN03606OtherRIRI BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230605000836 RI Practitioner - Nurse Practitioner 3072906171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2337727MAMDRegistered Nurse
APRN03606RIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wood River Health Services, Inc. CurrentSince May 24, 2023 Accepting new patients
Tahoe Carson Valley Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Barton Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Thames Eye Group, PC Past Accepting new patients

Locations

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

823 Main St
Hope Valley, RI 02832

17 Wells St
Ste 102
Westerly, RI 02891
Phone (401) 596-0339

17 Wells St
Westerly, RI 02891
Phone (401) 348-2020

Interoperability endpoints

  • Direct secure messaging: maria.mcgurrin.p1@direct.wrhsrhodeisland.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1306422779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CAPTAIN JOHN JACOBS ROAD",
            "address_2": "UNIT 208",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143329",
            "telephone_number": "617-449-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CAPTAIN JOHN JACOBS RD APT 208",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145372",
            "telephone_number": "617-449-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGURRIN",
        "first_name": "MARIA",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2337727",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95019233",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN03606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENCE NUMBER",
            "identifier": "RN2337727",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BOARD OF NURSING",
            "identifier": "APRN03606",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.