Marybeth Adams-Khoury, CPNP-PC
Individual provider Active NPI Pediatrics Physician · Brockton, MA
NPI 1518436153 · NPPES record last updated Nov 13, 2018
Key facts
- NPI
- 1518436153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- RN231553 (MA)
- Practice address
- 63 Main St FL 3
Brockton, MA 02301-4042 - Phone
- (508) 559-6699
- NPI assigned
- Nov 13, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN231553 | MA | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | RN231553 | MA | Yes |
Addresses
Primary practice location
63 Main St FL 3
Brockton, MA 02301-4042
Mailing address
82 Cypress Dr
Brockton, MA 02301-2970
Phone (508) 587-9081
Other providers in Brockton, MA
- Acclaim MSG LLC
- Maboh Achiri
- Penelope Jackson Ackley
- Andrew Acosta
- Danielle Adam
- Alicemary Aspell Adams
- Amy Leadbetter Adams
- Rhashida Adams
- Susanne Adams
- Adaptive Prosthetic and Orthotic Technologies, Inc.
All providers in Brockton, MA · Pediatrics Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.