Active NPI
Kepha Poisson, LPN
- Licensed Practical Nurse
- Malden, MA
National Provider Identifier
1609635754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LN101808
- Practice address
- 300 Winthrop St
Malden, MA 02148-6825 - Phone
- (678) 886-0345
- NPI assigned
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LN101808 | MA | Primary |
Addresses
Primary practice location
300 Winthrop St
Malden, MA 02148-6825
Mailing address
120 Madison St Apt 2
Malden, MA 02148-6825
Phone (781) 462-7012
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 |
|---|---|---|---|
| LN101808 | MA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1609635754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 MADISON ST APT 2",
"city": "MALDEN",
"state": "MA",
"postal_code": "021486825",
"telephone_number": "781-462-7012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WINTHROP ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021486825",
"telephone_number": "678-886-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POISSON",
"first_name": "KEPHA",
"name_prefix": "Miss",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-11-04",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MA",
"license": "LN101808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.