Individual provider Active NPI

Kayla Anne Northam, APRN

  • Family Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1669064218
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
084237-23 Issued in NH
Practice address
One Medical Center Drive
Lebanon, NH 03756-1000
Phone
(603) 650-5261
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 084237-23 NH Primary
Registered Nurse 163W00000X 084237-21 NH

Addresses

Primary practice location

One Medical Center Drive
Lebanon, NH 03756-1000

Mailing address

One Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5261

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.dartmouth-hitchcock.org/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 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
I20210310000207 NH Practitioner - Nurse Practitioner 3173939568 Reassigns benefits to 2 organizations
I20230313001428 MA Practitioner - Nurse Practitioner 3173939568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

50 Staniford St
Boston, MA 02114-2517

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
084237-21NHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Apr 5, 2021 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Apr 5, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Mar 9, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Mar 9, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Apr 5, 2021 Accepting new patients
MW Wellness Ventures I, LLC Past Accepting new patients

Locations

50 Staniford St
Ste 600
Boston, MA 02114
Phone (617) 367-4800

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

52 Second Ave
Ste 3200
Waltham, MA 02451

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: northam.kayla.mgh@direct.partners.masshiway.net

Organizations & group practices 7

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 1

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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1669064218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHAM",
        "first_name": "KAYLA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "084237-23",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "084237-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.dartmouth-hitchcock.org/",
            "affiliation": "N",
            "endpointDescription": "DHMC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Lebanon",
            "address_1": "1 Medical Center Dr",
            "city": "Lebanon",
            "state": "NH",
            "country_code": "US",
            "postal_code": "037561000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.