Individual provider Active NPI

Judith Baldwin Boardman, PHD, RNCS

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Salem, MA
National Provider Identifier
1750593315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
131301 Issued in MA
Practice address
162 Federal St
4TH Floor
Salem, MA 01970-3248
Phone
(888) 682-2224
Fax
(978) 745-4307
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

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
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 131301 MA Primary

Addresses

Primary practice location

162 Federal St
4TH Floor
Salem, MA 01970-3248

Mailing address

162 Federal St
4TH Floor
Salem, MA 01970-3248
Phone (888) 682-2224

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
131301MAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750593315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 FEDERAL ST",
            "address_2": "4TH FLOOR",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703248",
            "telephone_number": "888-682-2224",
            "fax_number": "978-745-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 FEDERAL ST",
            "address_2": "4TH FLOOR",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703248",
            "telephone_number": "888-682-2224",
            "fax_number": "978-745-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "JUDITH",
        "middle_name": "BALDWIN",
        "name_prefix": "Dr.",
        "credential": "PHD, RNCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "131301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

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.