Individual provider Active NPI

Magdala Jeannite, RN

  • Adult Health Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1700782935
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2341875 Issued in MA
Practice address
1717 Main St
Brockton, MA 02301-7134
Phone
(508) 301-3444
Fax
(508) 638-5898
NPI assigned
Oct 15, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2341875 MA Primary

Addresses

Primary practice location

1717 Main St
Brockton, MA 02301-7134

Mailing address

1717 Main St
Brockton, MA 02301-7134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1700782935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017134",
            "telephone_number": "508-301-3444",
            "fax_number": "508-638-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANNITE",
        "first_name": "MAGDALA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2341875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.