Individual provider Active NPI

Kathleen A. Nopper, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Roslindale, MA
National Provider Identifier
1558604975
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202567 Issued in MA
Practice address
90 Birch St
Roslindale, MA 02131-3010
Phone
(617) 823-5230
Fax
(617) 325-6654
NPI assigned
Apr 3, 2013
Last updated
Mar 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202567 MA Primary

Addresses

Primary practice location

90 Birch St
Roslindale, MA 02131-3010

Mailing address

55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170612002303 MA Practitioner - Nurse Practitioner 7113295312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5729CTMDProfessional Counselor
202567MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Mar 1, 2022 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

Interoperability endpoints

  • Direct secure messaging: knopper@landmarkhealth-direct.org
  • Direct secure messaging: ms_knopper@landmarkhealth-direct.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1558604975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BIRCH ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313010",
            "telephone_number": "617-823-5230",
            "fax_number": "617-325-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOPPER",
        "first_name": "KATHLEEN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "202567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.