Active NPI
Ann Guttendorf, N.P.
- Adult Health Nurse Practitioner
- Boston, MA
National Provider Identifier
1659423168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 162069
- Practice address
- 55 Fruit St
MGH- Ellison 11
Boston, MA 02114-2621 - Phone
- (617) 724-5110
- Fax
- (617) 724-5150
- NPI assigned
- Jan 17, 2007
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 162069 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
MGH- Ellison 11
Boston, MA 02114-2621
Mailing address
55 Fruit Street
MGH- Ellison 11
Boston, MA 02114
Phone (617) 724-5110
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162069 | MA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659423168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT STREET",
"address_2": "MGH- ELLISON 11",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-724-5110",
"fax_number": "617-724-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"address_2": "MGH- ELLISON 11",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-724-5110",
"fax_number": "617-724-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTTENDORF",
"first_name": "ANN",
"credential": "N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "162069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.