Active NPI
Lisa Marie Bozzuto, R.N.
- Registered Nurse
- Stockbridge, MA
National Provider Identifier
1700099462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 217416
- Practice address
- 25 Main Street
Stockbridge, MA 01262-0962 - Phone
- (413) 298-5511
- NPI assigned
- May 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 217416 | MA | Primary |
Addresses
Primary practice location
25 Main Street
Stockbridge, MA 01262-0962
Mailing address
623 Main St
Great Barrington, MA 01230-2002
Phone (413) 528-9392
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217416 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700099462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 MAIN ST",
"city": "GREAT BARRINGTON",
"state": "MA",
"postal_code": "012302002",
"telephone_number": "413-528-9392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 MAIN STREET",
"city": "STOCKBRIDGE",
"state": "MA",
"postal_code": "012620962",
"telephone_number": "413-298-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZZUTO",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "217416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.