Individual provider Active NPI

Kristen Monique Beard

  • General Practice Registered Nurse
  • Roxbury, MA
National Provider Identifier
1346883980
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
2313284 Issued in MA
Practice address
45 Dimock St
Roxbury, MA 02119-1208
Phone
(617) 442-8800
Fax
(617) 442-4088
NPI assigned
Oct 27, 2019
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 2313284 MA Primary

Addresses

Primary practice location

45 Dimock St
Roxbury, MA 02119-1208

Mailing address

229 Marion St Apt 1
Boston, MA 02128-4033
Phone (202) 423-9548

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
2313284MAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1346883980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 MARION ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021284033",
            "telephone_number": "202-423-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-442-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "KRISTEN",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "2313284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.