Individual provider Active NPI

Kayla Wholey, NP

  • Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1720784408
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2313888 Issued in MA
Practice address
275 Varnum Ave Ste 201
Lowell, MA 01854-2141
Phone
(978) 452-9700
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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 RN2313888 MA Primary

Addresses

Primary practice location

275 Varnum Ave Ste 201
Lowell, MA 01854-2141

Mailing address

275 Varnum Ave Ste 201
Lowell, MA 01854-2141
Phone (978) 452-9700

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
I20230410000099 MA Practitioner - Nurse Practitioner 7911372792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Group PCGroup PAC ID 5193612919, 12 clinicians

Practice addresses (Care Compare)

275 Varnum Ave
Suite 201
Lowell, MA 01854-2141
Phone (978) 452-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2313888MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Group PC CurrentSince Feb 6, 2023 Accepting new patients
Premier Diagnostic Services, Inc PastSince Feb 8, 2023 Accepting new patients

Locations

275 Varnum Ave
#201
Lowell, MA 01854
Phone (978) 452-9700

275 Varnum Ave
Ste 201
Lowell, MA 01854
Phone (978) 452-9700

Interoperability endpoints

  • Direct secure messaging: kwholey91038@tuftsmedicine.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1720784408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 201",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542141",
            "telephone_number": "978-452-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 201",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542141",
            "telephone_number": "978-452-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHOLEY",
        "first_name": "KAYLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2313888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.