Individual provider Active NPI

Iris Gwynne, FNP-C

  • Family Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1407238975
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2290902 Issued in MA
Practice address
34 Haverhill St
Lawrence, MA 01841-2884
Phone
(978) 686-0090
Fax
(978) 687-2154
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2290902 MA Primary

Addresses

Primary practice location

34 Haverhill St
Lawrence, MA 01841-2884

Mailing address

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151228001797 MA Practitioner - Nurse Practitioner 6901107416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Lawrence Family Health Center IncGroup PAC ID 0446221956, 118 clinicians

Practice addresses (Care Compare)

150 Park St
Lawrence, MA 01841-2517
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Hospital & facility affiliations

  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2290902MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center, Inc. CurrentSince Oct 19, 2015 Accepting new patients
Greater Lawrence Family Health Center Inc CurrentSince Oct 19, 2015 Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

Interoperability endpoints

  • Direct secure messaging: iris.gwynne.1@23857.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1407238975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090",
            "fax_number": "978-687-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090",
            "fax_number": "978-687-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYNNE",
        "first_name": "IRIS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2290902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.