Individual provider Active NPI

Mary Byrne Welch, RN FNP, AOCN

  • Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1417944372
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN479278 Issued in CA
Practice address
2810 Long Beach BL
Todd Cancer Institute at Long Beach Memorial
Long Beach, CA 90806
Phone
(562) 933-0961
Fax
(560) 933-0960
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN479278 CA Primary

Addresses

Primary practice location

2810 Long Beach BL
Todd Cancer Institute at Long Beach Memorial
Long Beach, CA 90806

Mailing address

2810 Long Beach Blvd
Todd Cancer Institute at Long Beach Memorial
Long Beach, CA 90806
Phone (562) 933-0961

Other identifiers 2

IdentifierTypeStateIssuer
500022897OtherRAILROAD MEDICARE
NPO114960OtherBLUE SHIELD

Other names 1

  • Mary Catherine Byrne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040220001131 CA Practitioner - Nurse Practitioner 1759276330

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN479278CAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mwelch175413@direct.memorialcare.org

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1417944372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 LONG BEACH BLVD",
            "address_2": "TODD CANCER INSTITUTE AT LONG BEACH MEMORIAL",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-933-0961",
            "fax_number": "560-933-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 LONG BEACH BL",
            "address_2": "TODD CANCER INSTITUTE AT LONG BEACH MEMORIAL",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-933-0961",
            "fax_number": "560-933-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "MARY",
        "middle_name": "BYRNE",
        "credential": "RN FNP, AOCN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "RN479278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500022897",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "NPO114960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BYRNE",
            "middle_name": "CATHERINE",
            "credential": "RN, MS, FNP, AOCN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.