Active NPI
Patricia Thibodeau, RN
- Registered Nurse
- Framingham, MA
National Provider Identifier
1487854170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 119764
- Practice address
- 19 Concord St
Framingham, MA 01702-8301 - Phone
- (508) 370-0113
- Fax
- (508) 370-3637
- NPI assigned
- Jul 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 119764 | MA | Primary |
Addresses
Primary practice location
19 Concord St
Framingham, MA 01702-8301
Mailing address
19 Concord St
Framingham, MA 01702-8301
Phone (508) 370-0113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1320858 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 119764 | MA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward M. Kennedy Community Health Center, Inc | Past | Accepting new patients | |
| Edward M. Kennedy Community Health Center, Inc | Past | Accepting new patients |
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.
-
- Clinic Pharmacy
- Worcester, MA
- NPI 1013048347
-
- Federally Qualified Health Center (FQHC)
- Worcester, MA
- NPI 1316324650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1487854170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 CONCORD ST",
"city": "FRAMINGHAM",
"state": "MA",
"postal_code": "017028301",
"telephone_number": "508-370-0113",
"fax_number": "508-370-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 CONCORD ST",
"city": "FRAMINGHAM",
"state": "MA",
"postal_code": "017028301",
"telephone_number": "508-370-0113",
"fax_number": "508-370-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAU",
"first_name": "PATRICIA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "119764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1320858",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Framingham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.