Individual provider Active NPI

Addie Lawrence, N.P.

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1639231426
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
264754 Issued in MA
Practice address
416 Belmont St
Worcester, MA 01604-1086
Phone
(508) 756-1808
Fax
(508) 756-1808
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 264754 MA Primary

Addresses

Primary practice location

416 Belmont St
Worcester, MA 01604-1086

Mailing address

416 Belmont St
Worcester, MA 01604-1086
Phone (508) 756-1808

Other identifiers 3

IdentifierTypeStateIssuer
0710211MedicaidMA
9771476MedicaidMA
M20928OtherMAGROUP MEDICARE

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
I20070115000052 MA Practitioner - Nurse Practitioner 8628078789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Worcester Internal Medicine, Inc.Group PAC ID 8022089440, 9 clinicians

Practice addresses (Care Compare)

416 Belmont St
Suite 1
Worcester, MA 01604-1086
Phone (508) 756-6609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
264759MAMDFamily Medicine Physician
264754MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Worcester Internal Medicine, Inc. CurrentSince Dec 1, 2008 Accepting new patients
Bernard a Westerling III, MD, LLC Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients
Reliant Medical Group, Inc PastSince Oct 15, 2007 Accepting new patients

Locations

416 Belmont St
Ste 1
Worcester, MA 01604
Phone (508) 756-6609

416 Belmont St
Worcester, MA 01604
Phone (508) 756-1808

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFCDD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1639231426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041086",
            "telephone_number": "508-756-1808",
            "fax_number": "508-756-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041086",
            "telephone_number": "508-756-1808",
            "fax_number": "508-756-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "ADDIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "264754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0710211",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9771476",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "M20928",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.