Individual provider Active NPI

Jaclin Morrison, AGNP

  • Gerontology Nurse Practitioner
  • North Andover, MA
National Provider Identifier
1639730526
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2264679 Issued in MA
Practice address
575 Turnpike St Ste 25
North Andover, MA 01845-5937
Phone
(789) 290-4646
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2264679 MA Primary

Addresses

Primary practice location

575 Turnpike St Ste 25
North Andover, MA 01845-5937

Mailing address

575 Turnpike St Ste 25
North Andover, MA 01845-5937
Phone (978) 290-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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

Enrollment IDStateProvider typePAC IDDetails
I20190920001707 MA Practitioner - Nurse Practitioner 4385974187 Reassigns benefits to 1 organization
I20210121001505 NH Practitioner - Nurse Practitioner 4385974187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Community Medical Services PCGroup PAC ID 5991016933, 11 clinicians

Practice addresses (Care Compare)

575 Turnpike St
Suite 25
North Andover, MA 01845-5937
Phone (978) 290-4646

674 W Hollis St
Nashua, NH 03062-1347
Phone (978) 290-4646

Hospital & facility affiliations

  • Accentcare Home Health of Massachusetts Home health agency, Fall River, MA, CCN 227203
  • Bayada Home Health Care, Inc Home health agency, Wilmington, MA, CCN 227576
  • Enhabit Home Health Home health agency, Andover, MA, CCN 227500
  • Interim Healthcare Home health agency, Manchester, NH, CCN 307049
  • Caretenders Home health agency, Needham Heights, MA, CCN 227269
  • Ascend Hospice Hospice, Worcester, MA, CCN 221566
  • Elliot Hospital Hospital, Manchester, NH, CCN 300012
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1639730526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 25",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "978-290-4646",
            "fax_number": "978-290-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 25",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "789-290-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "JACLIN",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2264679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.