Individual provider Active NPI

Patricia Maria Wefald, N.P.

  • Adult Health Nurse Practitioner
  • Braintree, MA
National Provider Identifier
1659620623
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2264061 Issued in MA
Practice address
111 Grossman Dr.
Braintree, MA 02184
Phone
(781) 849-2400
Fax
(781) 849-2593
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2264061 MA Primary

Addresses

Primary practice location

111 Grossman Dr.
Braintree, MA 02184

Mailing address

111 Grossman Dr.
Braintree, MA 02184
Phone (781) 849-2400

Other names 1

  • Patricia Callahan Former name

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

LicenseStateTypeSpecialty
RN2264061MAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1659620623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR.",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "02184",
            "telephone_number": "781-849-2400",
            "fax_number": "781-849-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR.",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "02184",
            "telephone_number": "781-849-2400",
            "fax_number": "781-849-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEFALD",
        "first_name": "PATRICIA",
        "middle_name": "MARIA",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2264061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "CALLAHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.