Individual provider Active NPI

Maureen A Doyle, RNCS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Plymouth, MA
National Provider Identifier
1700804119
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
124314 Issued in MA
Practice address
64 Industrial Park Rd
Plymouth, MA 02360-4881
Phone
(617) 847-1950
Fax
(617) 774-1490
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Clinical Nurse Specialist 364SP0808X 124314 MA Primary

Addresses

Primary practice location

64 Industrial Park Rd
Plymouth, MA 02360-4881

Mailing address

64 Industrial Park Rd
Plymouth, MA 02360-4881
Phone (617) 847-1950

Other identifiers 1

IdentifierTypeStateIssuer
PN0733OtherMABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050901000136 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 8628000445 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124314MAMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince May 1, 2022 Accepting new patients
South Shore Mental Health Center, Inc. CurrentSince Apr 10, 2000 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince May 1, 2022 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

11 Bay State Ct
Brewster, MA 02631
Phone (508) 255-0111

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

64 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 747-2012

500 Victory Rd
Quincy, MA 02171
Phone (617) 774-1040

Organizations & group practices 3

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700804119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "MAUREEN",
        "middle_name": "A",
        "credential": "RNCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MA",
            "license": "124314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PN0733",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.