Organization Active NPI

Lamothe Primary Care PLLC

  • Family Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1326773680
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LAMOTHE PRIMARY CARE PLLC
Practice address
225 Quincy Ave
Brockton, MA 02302-2864
Phone
(954) 478-6484
NPI assigned
Jul 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Lucienne Lamothe, NPNPI 1992358576
Title
Nurse Practitioner
Phone
(954) 478-6484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

225 Quincy Ave
Brockton, MA 02302-2864

Mailing address

117 Tower St
Dedham, MA 02026-3830
Phone (954) 478-6484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220908002442 MA Part B Supplier - Clinic/Group Practice 0749664894 Receives reassigned benefits from 1 practitioner
Practice locations: Randolph, MA

National Provider Directory

National Provider Directory

Locations

10 Mazzeo Dr
Ste 201J
Randolph, MA 02368
Phone (508) 419-0990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1326773680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TOWER ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020263830",
            "telephone_number": "954-478-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 QUINCY AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022864",
            "telephone_number": "954-478-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMOTHE PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "LAMOTHE",
        "authorized_official_first_name": "LUCIENNE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "954-478-6484",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.