Active NPI
Grace R Wilson, RN
- Registered Nurse
- Lynn, MA
National Provider Identifier
1346869062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN266215
- Practice address
- 1 Herbert St Unit B
Lynn, MA 01902-3808 - Phone
- (617) 821-4923
- NPI assigned
- Apr 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN266215 | MA | Primary |
Addresses
Primary practice location
1 Herbert St Unit B
Lynn, MA 01902-3808
Mailing address
1 Herbert St Unit B
Lynn, MA 01902-3808
Phone (617) 821-4923
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN266215 | MA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Homecare Services LLC | Single Specialty | Current | Accepting new patients |
| Jordan Homecare Services | Single Specialty | Current | Accepting new patients |
Organizations & group practices 2
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": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1346869062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HERBERT ST UNIT B",
"city": "LYNN",
"state": "MA",
"postal_code": "019023808",
"telephone_number": "617-821-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HERBERT ST UNIT B",
"city": "LYNN",
"state": "MA",
"postal_code": "019023808",
"telephone_number": "617-821-4923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "GRACE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-13",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN266215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.