Individual provider Active NPI

Donna R Santimore, PMHCNS - BC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Leominster, MA
National Provider Identifier
1306940549
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
150095 Issued in MA
Practice address
40 Spruce St
Leominster, MA 01453
Phone
(978) 534-6116
Fax
(978) 534-3294
NPI assigned
Sep 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 150095 MA Primary

Addresses

Primary practice location

40 Spruce St
Leominster, MA 01453

Mailing address

40 Spruce St
Leominster, MA 01453-3361
Phone (978) 534-6116

Other practice location 1

10 Parker St
Gardner, MA 01440-3866
Phone (978) 630-4760

Other names 1

  • Donna R Tully Former name

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

State licenses

LicenseStateTypeSpecialty
150095MAMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1306940549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SPRUCE ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533361",
            "telephone_number": "978-534-6116",
            "fax_number": "978-534-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SPRUCE ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-6116",
            "fax_number": "978-534-3294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Parker St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014403866",
            "country_code": "US",
            "telephone_number": "978-630-4760",
            "fax_number": "978-630-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIMORE",
        "first_name": "DONNA",
        "middle_name": "R",
        "credential": "PMHCNS - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MA",
            "license": "150095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "TULLY",
            "middle_name": "R",
            "credential": "PMHCNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.