Individual provider Active NPI

Isabelle Clyde

  • Primary Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1447030283
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2024055766 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 732-7865
NPI assigned
Sep 29, 2023
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024193348 VA
Primary Care Nurse Practitioner 363LP2300X 2024055766 MA Primary
Registered Nurse 163W00000X 0001336667 VA
General Practice Registered Nurse 163WG0000X RN2371552 MA

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

61 Hemenway St Apt 3
Boston, MA 02115-2962
Phone (518) 935-7407

Other practice location 1

120 Kings Way Ste 2700
Williamsburg, VA 23185-2554
Phone (757) 221-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250623001954 VA Practitioner - Nurse Practitioner 0446762884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

120 Kings Way
Suite 3300 and 3500
Williamsburg, VA 23185-2511
Phone (757) 253-0051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001336667VAMDRegistered Nurse
RN2371552MAMDGeneral Practice Registered Nurse
2024055766MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jun 11, 2025 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. CurrentSince Jun 11, 2025 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

120 Kings Way
Ste 2700
Williamsburg, VA 23185
Phone (757) 221-0110

120 Kings Way
Ste 3300
Williamsburg, VA 23185
Phone (757) 221-0750

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1447030283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 HEMENWAY ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152962",
            "telephone_number": "518-935-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-7865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Kings Way Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231852554",
            "country_code": "US",
            "telephone_number": "757-221-0110",
            "fax_number": "757-221-0851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "ISABELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024193348",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "2024055766",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001336667",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "RN2371552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.