Jillian Lucey Kavanagh, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2264536 Issued in MA

Practice address

4 Centennial Dr Ste 204
Peabody, MA 01960-7930

Phone

(978) 977-0351

NPI assigned

Dec 9, 2018

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kavanagh.jillian.nsmc@direct.partners.masshiway.net

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.

• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment NPD

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

{
    "created_epoch": "1544313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544313600000",
    "number": "1699246199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 ESSEX AVE",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302301",
            "telephone_number": "978-808-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CENTENNIAL DR STE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607930",
            "telephone_number": "978-977-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "JILLIAN",
        "middle_name": "LUCEY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-09",
        "last_updated": "2018-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2264536",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2264536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katz Optometry, P.C.
• Ellis H Katz
• Julian Katz
• Tamar Katz
• Helen Kaulbach, MD
• Thomas Kevin Kavanaugh
• Robin Kazer Yannetti, LICSW
• Shyanne Ke
• Alexa Keating
• Deborah Ann Keenan, O.T.R.

• Family Nurse Practitioner in Peabody, MA
• Providers in Peabody, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.