Kathleen Heffernan, APN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bourne, MA
NPI 1548870710 · NPPES record last updated Jul 14, 2022
Key facts
- NPI
- 1548870710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN143164 (MA)
- Practice address
- 258 Main St Ste B1
Bourne, MA 02532-3251 - Phone
- (857) 263-3758
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Commonwealth of Massachusetts
Practice addresses (Care Compare)
165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2000
49 Hillside St
Fall River, MA 02720-5211
Phone (508) 235-7400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210505001559 | MA | Practitioner - Nurse Practitioner | 9133538028 |
Reassigns benefits to 2 organizations Practice locations: Buzzards Bay, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN143164 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Commonwealth of Massachusetts | Current |
Accepting new patients | |
| Day to Day Psychiatric Care & Wellness PLLC | Current |
Accepting new patients | |
| The Commonwealth of Massachusetts | Current |
Accepting new patients | |
| The Commonwealth of Massachusetts | Current |
Accepting new patients | |
| Health Imperatives Inc. | Past | Accepting new patients |
Locations
165 Quincy St
Brockton, MA 02302
Phone (508) 897-2000
49 Hillside St
Fall River, MA 02720
Phone (508) 235-7200
40 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 732-3000
294 Pleasant St
Ste 205
Stoughton, MA 02072
Phone (781) 436-3352
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN143164 | MA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN143164 | MA | Yes |
Addresses
Primary practice location
258 Main St Ste B1
Bourne, MA 02532-3251
Mailing address
258 Main St Ste B1
Bourne, MA 02532-3251
Phone (508) 317-5900
Other practice location 1
165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2000
Other providers in Bourne, MA
- Carey Lynne Gould
- Hannah Mary Grassi
- Patrick Griffin
- Harbor Healing Arts LLC
- Scott M Harris
- Cheryl A Hitchings
- Brianne Horton
- Keralyn Ann Houde
- Sharon Marie Howarth
- John D Hughes
All providers in Bourne, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.