Individual provider Active NPI

Katherine A. Clifford, N.P

  • Nurse Practitioner
  • Newburyport, MA
National Provider Identifier
1710004015
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
171621 Issued in MA
Practice address
1 Wallace Bashaw Way Ste 2003
Newburyport, MA 01950-3879
Phone
(978) 465-7719
NPI assigned
Mar 23, 2007
Last updated
Mar 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 171621 MA Primary

Addresses

Primary practice location

1 Wallace Bashaw Way Ste 2003
Newburyport, MA 01950-3879

Mailing address

28 Green St
Newburyport, MA 01950-2650
Phone (978) 465-7719

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
I20060125000796 MA Practitioner - Nurse Practitioner 6608890983 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171621MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Affiliated Group Practice, Inc. CurrentSince Oct 1, 2016 Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients

Locations

24 Morrill Pl
Ste 2
Amesbury, MA 01913
Phone (978) 462-9628

1 Wallace Bashaw Way
Ste 2003
Newburyport, MA 01950
Phone (978) 465-0635

21 Highland Ave
Ste 5
Newburyport, MA 01950
Phone (978) 255-4217

28 Green St
Newburyport, MA 01950
Phone (978) 465-1234

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1710004015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 GREEN ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502650",
            "telephone_number": "978-465-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALLACE BASHAW WAY STE 2003",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503879",
            "telephone_number": "978-465-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "KATHERINE",
        "middle_name": "A.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "171621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.