Individual provider Active NPI

Marie Laboissonniere, RN, CDOE

  • Diabetes Educator Registered Nurse
  • Providence, RI
National Provider Identifier
1659507218
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
24271 Issued in RI
Practice address
21 Peace St
Providence, RI 02907-1510
Phone
(401) 456-3309
Fax
(401) 456-3762
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 24271 RI Primary

Addresses

Primary practice location

21 Peace St
Providence, RI 02907-1510

Mailing address

200 High Service Ave
Marion Hall, 4TH FL.
North Providence, RI 02904-5113
Phone (401) 456-3309

Other identifiers 1

IdentifierTypeStateIssuer
RN24271OtherRILICENSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
24271RIMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1659507218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "address_2": "MARION HALL, 4TH FL.",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "telephone_number": "401-456-3309",
            "fax_number": "401-456-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PEACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-456-3309",
            "fax_number": "401-456-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABOISSONNIERE",
        "first_name": "MARIE",
        "credential": "RN, CDOE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "RI",
            "license": "24271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN24271",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.