Individual provider Active NPI

Kathryn Kieran, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, MA
National Provider Identifier
1689900946
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN280937 Issued in MA
Practice address
172 Lafayette St
Salem, MA 01970-4815
Phone
(978) 744-4033
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN280937 MA Primary

Addresses

Primary practice location

172 Lafayette St
Salem, MA 01970-4815

Mailing address

115 Mill St
WTP
Belmont, MA 02478-1064

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100204000496 MA Practitioner - Nurse Practitioner 5890838494 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN280937MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation CurrentSince Dec 10, 2009 Accepting new patients

Locations

115 Mill St
Stop 238
Belmont, MA 02478
Phone (617) 855-2677

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

Interoperability endpoints

  • Direct secure messaging: kieran.kathryn.mcl@direct.partners.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1689900946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "address_2": "WTP",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 LAFAYETTE ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704815",
            "telephone_number": "978-744-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERAN",
        "first_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN280937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.