Individual provider Active NPI

Deanna Tkachuk, RN

  • Registered Nurse
  • Groveland, MA
National Provider Identifier
1437392727
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
260881 Issued in MA
Practice address
4 Pinewood LN
Groveland, MA 01834-1621
Phone
(978) 828-2267
NPI assigned
Apr 16, 2009
Last updated
Apr 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 260881 MA Primary

Addresses

Primary practice location

4 Pinewood LN
Groveland, MA 01834-1621

Mailing address

4 Pinewood LN
Groveland, MA 01834-1621
Phone (978) 828-2267

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
260881MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1437392727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PINEWOOD LN",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341621",
            "telephone_number": "978-828-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PINEWOOD LN",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341621",
            "telephone_number": "978-828-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACHUK",
        "first_name": "DEANNA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "260881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveland, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.