Individual provider Active NPI

Julia Deborah Laflamme, NP

  • Gerontology Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1477754554
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
258397 Issued in MA
Practice address
36 Dearborn St
Roxbury, MA 02119-2552
Phone
(617) 440-1615
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 258397 MA Primary

Addresses

Primary practice location

36 Dearborn St
Roxbury, MA 02119-2552

Mailing address

36 Dearborn St
Roxbury, MA 02119-2552
Phone (617) 440-1615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160108001034 MA Order and Referring Only - Nurse Practitioner 4082916937

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258397MAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1477754554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DEARBORN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192552",
            "telephone_number": "617-440-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 DEARBORN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192552",
            "telephone_number": "617-440-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFLAMME",
        "first_name": "JULIA",
        "middle_name": "DEBORAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "258397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.