Individual provider Active NPI

Jovan Emmanuel Sematimba, RN

  • Registered Nurse
  • Medford, MA
National Provider Identifier
1578424057
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2345292 Issued in MA
Practice address
103 George St
Medford, MA 02155-5516
Phone
(781) 605-7883
NPI assigned
Nov 24, 2025
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2345292 MA Primary

Addresses

Primary practice location

103 George St
Medford, MA 02155-5516

Mailing address

103 George St
Medford, MA 02155-5516
Phone (781) 605-7883

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2345292MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1578424057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GEORGE ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555516",
            "telephone_number": "781-605-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GEORGE ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555516",
            "telephone_number": "781-605-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMATIMBA",
        "first_name": "JOVAN",
        "middle_name": "EMMANUEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2345292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.