Active NPI
Anna Merrill
- Psychologist
- Worcester, MA
National Provider Identifier
1528515822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 11606
- Practice address
- 800 Main St
Worcester, MA 01610-6403 - Phone
- (774) 415-0003
- NPI assigned
- Sep 2, 2016
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11606 | MA | Primary |
Addresses
Primary practice location
800 Main St
Worcester, MA 01610-6403
Mailing address
800 Main St
Worcester, MA 01610-6403
Phone (774) 415-0003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11606 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1528515822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016106403",
"telephone_number": "774-415-0003",
"fax_number": "614-355-7533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016106403",
"telephone_number": "774-415-0003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-02",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11606",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.