Lisa Ellen Thibodeau, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN239148 Issued in MA

Practice address

85 Herrick St
North Shore Birth Center
Beverly, MA 01915-1790

Phone

(978) 927-7880

Fax

(978) 524-6082

NPI assigned

May 7, 2013

Last updated

Feb 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lthibodeau117104@direct.challiance.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cambridge Public Health Commission

  dba Cambridge Health Alliance

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  NPD
• Jordan Physician Associates, Inc.

  dba BIDH-Plymouth Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD (past)
• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1316382120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "NORTH SHORE BIRTH CENTER",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-927-7880",
            "fax_number": "978-524-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "NORTH SHORE BIRTH CENTER",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-927-7880",
            "fax_number": "978-524-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "LISA",
        "middle_name": "ELLEN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN239148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Freedom Wellness Group, Inc (Elements Therapeutic Massage Beverly)
• The Verbal ABA Clinic, LLC (Speech Therapy Group)
• Therapy for Intentional Living, Inc.
• Therapy From the Heart
• Savannah Lyvonne Theriault, BT
• Thomas P Rafferty DDS, LLC
• Philip A Thomason, MD
• Brynn Thompson, LICSW
• Jodi M Thompson, CNP
• Kerry M. Thompson, LICSW

• Advanced Practice Midwife in Beverly, MA
• Providers in Beverly, MA by specialty
• Advanced Practice Midwife in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.