Jacqueline Ann Landry, MSN, APRN, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2273331 Issued in MA

Practice address

323 Lowell St
Andover, MA 01810-4659

Phone

(978) 475-2731

NPI assigned

Jul 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Ann Myette Former name

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andover Obstetrics and Gynecological Associates PCGroup PAC ID 0345224648, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Andover Obstetrics and Gynecological Associates, PC

  • Specialist
  • Andover, MA
  • NPI 1831304237
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence General Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639267200000",
    "number": "1679144364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SAWYER AVE",
            "city": "ATKINSON",
            "state": "NH",
            "postal_code": "038112441",
            "telephone_number": "508-498-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 LOWELL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018104659",
            "telephone_number": "978-475-2731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Elliot Way",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031033599",
            "country_code": "US",
            "telephone_number": "603-663-7520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "MSN,  APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-12-12",
        "certification_date": "2021-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NH",
            "license": "065494-21",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2273331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MYETTE",
            "middle_name": "ANN",
            "credential": "BSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Beth Kowalski, MS, CLS
• Claire Kramer, LMHC
• Juliya Krasnopolsky
• Richard J Lam, DMD
• Nancy C Landay, M.D.
• Adam M Lang, DPM
• Karen T Lang, LICSW
• Mary Ellen Langdon, PT
• Constance Alta Langer, OTR/L
• John Thomas Lapusata

• Nurse Practitioner in Andover, MA
• Providers in Andover, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.