Individual provider Active NPI

Fostina Aidoo Rolle, LPN

  • Licensed Practical Nurse
  • Worcester, MA
National Provider Identifier
1326365826
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN69895 Issued in MA
Practice address
30 Intervale Rd
Worcester, MA 01602
Phone
(508) 797-0486
NPI assigned
Apr 23, 2010
Last updated
Apr 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN69895 MA Primary

Addresses

Primary practice location

30 Intervale Rd
Worcester, MA 01602

Mailing address

30 Intervale Rd
Worcester, MA 01602-2038
Phone (508) 797-0486

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

State licenses

LicenseStateTypeSpecialty
LN69895MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1326365826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 INTERVALE RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022038",
            "telephone_number": "508-797-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 INTERVALE RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01602",
            "telephone_number": "508-797-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLE",
        "first_name": "FOSTINA",
        "middle_name": "AIDOO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN69895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.