Individual provider Active NPI

Sandra Ann Mathieu, RN-CS FNP

  • Registered Nurse
  • Pawtucket, RI
National Provider Identifier
1720061765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
NPP31617 Issued in RI
Practice address
100 Smithfield Ave
Pawtucket, RI 02860-3474
Phone
(401) 725-0900
NPI assigned
Nov 23, 2005
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
Registered Nurse 163W00000X NPP31617 RI Primary

Addresses

Primary practice location

100 Smithfield Ave
Pawtucket, RI 02860-3474

Mailing address

100 Smithfield Ave
Pawtucket, RI 02860-3474
Phone (401) 725-0900

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

State licenses

LicenseStateTypeSpecialty
NPP31617RIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720061765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMITHFIELD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028603474",
            "telephone_number": "401-725-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SMITHFIELD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028603474",
            "telephone_number": "401-725-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN-CS FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "NPP31617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

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.

Verify at the official NPI Registry.