Individual provider Active NPI

Lee J Jarnagin

  • Pediatric Registered Nurse
  • Somerville, MA
National Provider Identifier
1437297447
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
RN161401 Issued in MA
Practice address
300 Broadway
Somerville, MA 02145-2935
Phone
(617) 284-7000
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN161401 MA Primary

Addresses

Primary practice location

300 Broadway
Somerville, MA 02145-2935

Mailing address

300 Broadway
Somerville, MA 02145-2935
Phone (617) 284-7000

Other identifiers 1

IdentifierTypeStateIssuer
110074839AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN161401MAMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Jun 15, 2011 Accepting new patients
Cambridge Public Health Commission CurrentSince Jun 15, 2011 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

300 Broadway
Somerville, MA 02145
Phone (617) 284-7000

Interoperability endpoints

  • Direct secure messaging: ljarnagin6622@direct.challiance.masshiway.net

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1437297447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452935",
            "telephone_number": "617-284-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452935",
            "telephone_number": "617-284-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARNAGIN",
        "first_name": "LEE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN161401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110074839A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.