Individual provider Active NPI

Melissa Braga, RN

  • Nutrition Support Registered Nurse
  • Andover, MA
National Provider Identifier
1508535543
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support Registered NurseTaxonomy code 163WN1003X
License
RN2313754 Issued in MA
Practice address
300 Brickstone SQ Ste 201
Andover, MA 01810-1497
Phone
(978) 954-7310
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Registered Nurse 163WN1003X RN2313754 MA Primary

Addresses

Primary practice location

300 Brickstone SQ Ste 201
Andover, MA 01810-1497

Mailing address

7 Edith Dr
Tewksbury, MA 01876-3259
Phone (978) 973-0093

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
RN2313754MAMDNutrition Support Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1508535543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 EDITH DR",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763259",
            "telephone_number": "978-973-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BRICKSTONE SQ STE 201",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101497",
            "telephone_number": "978-954-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGA",
        "first_name": "MELISSA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "MA",
            "license": "RN2313754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.