Active NPI
John Job
- Psychiatric/Mental Health Nurse Practitioner
- Worcester, MA
National Provider Identifier
1407393010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN2271934
- Practice address
- 130 Lincoln St Ste 6
Worcester, MA 01605-2430 - Phone
- (774) 530-6955
- Fax
- (774) 530-6956
- NPI assigned
- Jan 21, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2271934 | MA | Primary |
Addresses
Primary practice location
130 Lincoln St Ste 6
Worcester, MA 01605-2430
Mailing address
130 Lincoln St Ste 6
Worcester, MA 01605-2430
Phone (774) 530-6955
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
35 Harvard St
Suite 217
Worcester, MA 01609-2850
Phone (774) 530-6955
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care4Us Wellness Center LLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Day to Day Psychiatric Care & Wellness PLLC | Past | Accepting new patients | |
| Health Imperatives Inc. | Past | Accepting new patients |
Locations
130 Lincoln St
Ste 6
Worcester, MA 01605
Phone (774) 530-6955
Organizations & group practices 4
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Brockton, MA
- NPI 1871091553
-
- Clinical Social Worker
- Brockton, MA
- NPI 1689720302
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Stoughton, MA
- NPI 1518445378
-
- Non-Surgical Family Planning Clinic/Center
- New Bedford, MA
- NPI 1013051614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538697600000",
"number": "1407393010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 LINCOLN ST STE 6",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052430",
"telephone_number": "774-530-6955",
"fax_number": "774-530-6956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 LINCOLN ST STE 6",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052430",
"telephone_number": "774-530-6955",
"fax_number": "774-530-6956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOB",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-21",
"last_updated": "2018-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "RN2271934",
"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 Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.