Individual provider Active NPI

Colleen Adris Livingstone, NP

  • Nurse Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1508802547
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN196643 Issued in MA
Practice address
150 S. Huntington Ave
(111) Ho
Jamaica Plain, MA 02130-4893
Phone
(857) 364-2471
Fax
(857) 364-4343
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 65316 DC
Nurse Practitioner 363L00000X RN196643 MA Primary

Addresses

Primary practice location

150 S. Huntington Ave
(111) Ho
Jamaica Plain, MA 02130-4893

Mailing address

150 S. Huntington Ave
(111) Ho
Jamaica Plain, MA 02130-4893
Phone (857) 364-2471

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
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1508802547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S. HUNTINGTON AVE",
            "address_2": "(111) HO",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304893",
            "telephone_number": "857-364-2471",
            "fax_number": "857-364-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S. HUNTINGTON AVE",
            "address_2": "(111) HO",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304893",
            "telephone_number": "857-364-2471",
            "fax_number": "857-364-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTONE",
        "first_name": "COLLEEN",
        "middle_name": "ADRIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "DC",
            "license": "65316",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN196643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.