Theresa Naomi Macdougall, CERTIFIED NURSE PRAC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN03228 Issued in RI

Practice address

531 Faunce Corner Rd
Dartmouth, MA 02747-1242

Phone

(508) 996-3991

NPI assigned

Mar 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Ms. Theresa Naomi Suter Former name

Medicare fee-for-service enrollment

Enrolled in PA, RI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physician Associates of New England PCGroup PAC ID 9931236395, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

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

• Emergency Physician Associates of New England PC

  • Emergency Medicine Physician
  • Wakefield, RI
  • NPI 1427381052

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Pinnacle Health Emergency Department Services LLC

  • Emergency Medicine Physician
  • Harrisburg, PA
  • NPI 1487693404

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1588804686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Kenyon Ave",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794216",
            "country_code": "US",
            "telephone_number": "401-782-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDOUGALL",
        "first_name": "THERESA",
        "middle_name": "NAOMI",
        "name_prefix": "Mrs.",
        "credential": "CERTIFIED NURSE PRAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN284223",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN03228",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "951695",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110171739A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1583237",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2099584",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "SUTER",
            "middle_name": "NAOMI",
            "prefix": "MS.",
            "credential": "CERTIFIED NURSE PRAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Luciano-Baker
• Lunar Bloom Counseling
• Michael David Lygren, PT
• Karine Maalouf-Kaleshian, M.D.
• Cheyenne Maccord-Moniz
• Andrew Paul Macedo, MA BLS
• Bethany Macedo, ATC
• Sara Mackinstry
• Stephen Mackler, M.D.
• Ivy Smith Macmahon, LICSW

• Nurse Practitioner in Dartmouth, MA
• Providers in Dartmouth, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.