Individual provider Active NPI

Meredith Anne Johnson

  • Clinical Social Worker
  • Chelsea, MA
National Provider Identifier
1730497157
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
301 Broadway
Chelsea, MA 02150-2807
Phone
(617) 889-3300
NPI assigned
Sep 20, 2010
Last updated
Jan 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MA Primary

Addresses

Primary practice location

301 Broadway
Chelsea, MA 02150-2807

Mailing address

616 Boston Ave Ste 2F
Medford, MA 02155-1377
Phone (978) 944-2544

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141107000470 MA Practitioner - Clinical Social Worker 5395967343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charter LTC LLCGroup PAC ID 0840674578, 20 clinicians
Charter Health PCGroup PAC ID 1153604079, 26 clinicians

Practice addresses (Care Compare)

55 Highland Ave
Suite 304
Salem, MA 01970-2100
Phone (978) 354-4611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118534MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Suffolk Community Services Inc. CurrentSince Sep 23, 2014 Accepting new patients
Charter Health PC CurrentSince Jan 1, 2025 Accepting new patients
Charter LTC LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

301 Broadway
Chelsea, MA 02150
Phone (617) 889-4860

265 Beach St
Revere, MA 02151
Phone (781) 289-9331

55 Highland Ave
Ste 304
Salem, MA 01970
Phone (978) 354-4611

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, 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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1730497157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 BOSTON AVE STE 2F",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551377",
            "telephone_number": "978-944-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502807",
            "telephone_number": "617-889-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MEREDITH",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.