Active NPI
Vivian Elizabeth Abernethy
- Nephrology Physician
- Boston, MA
National Provider Identifier
1710960232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 158788
- Practice address
- 720 Harrison Ave
Dob-4
Boston, MA 02118-2371 - Phone
- (617) 638-7480
- NPI assigned
- Nov 29, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 158788 | MA | Primary |
Addresses
Primary practice location
720 Harrison Ave
Dob-4
Boston, MA 02118-2371
Mailing address
650 Albany St
X-5
Boston, MA 02118-2647
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3198090 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 158788 | MA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evans Medical Foundation, Inc. | Nephrology | Past | Accepting new patients |
Organizations & group practices 1
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": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245110400000",
"number": "1710960232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 ALBANY ST",
"address_2": "X-5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 HARRISON AVE",
"address_2": "DOB-4",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182371",
"telephone_number": "617-638-7480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABERNETHY",
"first_name": "VIVIAN",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-29",
"last_updated": "2009-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "158788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3198090",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.