Nully Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

NULLY MEDICAL LLC

Practice address

156 Greeley St
Providence, RI 02904-1265

Phone

(401) 219-9525

NPI assigned

Mar 18, 2022

Organization subpart

No

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

Authorized official

Name

Abiola Akinboboye, NPNPI 1558804658

Title

Manager

Phone

(401) 219-9525

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

Enrollment records 2

Tax ID family

Nully Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nully Medical

  • Primary Care Clinic/Center
  • North Attleboro, MA
  • NPI 1174262703
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abiola Taju Akinboboye, FNP

  • Family Nurse Practitioner
  • Woonsocket, RI
  • NPI 1558804658

  MA

  Medicare reassignment NPD Authorized official
• David Lee Carnabuci, D.C.

  • Sports Physician Chiropractor
  • Plainville, MA
  • NPI 1275725350
  NPD (past)

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1639828569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SHELDONVILLE RD",
            "city": "NORTH ATTLEBORO",
            "state": "MA",
            "postal_code": "027606255",
            "telephone_number": "401-219-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 GREELEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041265",
            "telephone_number": "401-219-9525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Sheldonville Rd",
            "address_purpose": "LOCATION",
            "city": "North Attleboro",
            "state": "MA",
            "postal_code": "027606255",
            "country_code": "US",
            "telephone_number": "401-219-9525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NULLY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "AKINBOBOYE",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-219-9525",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "35 Sheldonville Rd",
            "city": "North Attleboro",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027606255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.