Individual provider Active NPI

Joan Kathleen Smyth, MSN RN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Everett, MA
National Provider Identifier
1477614675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
105254 Issued in MA
Practice address
173 Chelsea St
Lower Level
Everett, MA 02149
Phone
(781) 388-6244
Fax
(781) 388-6240
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 105254 MA Primary

Addresses

Primary practice location

173 Chelsea St
Lower Level
Everett, MA 02149

Mailing address

173 Chelsea St
Lower Level
Everett, MA 02149
Phone (781) 388-6244

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)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
105254MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477614675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 CHELSEA ST",
            "address_2": "LOWER LEVEL",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "02149",
            "telephone_number": "781-388-6244",
            "fax_number": "781-388-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 CHELSEA ST",
            "address_2": "LOWER LEVEL",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "02149",
            "telephone_number": "781-388-6244",
            "fax_number": "781-388-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "JOAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "MSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "105254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.