Individual provider Active NPI

Brenda Vigue

  • Psychiatric/Mental Health Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1760631923
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
194285 Issued in MA
Practice address
40 Church St
Lowell, MA 01852-6113
Phone
(978) 674-6744
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 194285 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP8053 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 194285 MA Primary

Addresses

Primary practice location

40 Church St
Lowell, MA 01852-6113

Mailing address

58 Jersey St
Dedham, MA 02026-4915
Phone (617) 640-3857

Other practice location 1

358 E Javelina Ave
Mesa, AZ 85210-6205
Phone (617) 640-3857

Other practice location 2

58 Jersey St
Dedham, MA 02026-4915
Phone (617) 640-3857

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
I20050719000161 MA Practitioner - Nurse Practitioner 7214964691

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP8053AZMDPsychiatric/Mental Health Nurse Practitioner
194285MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vinfen Corporation CurrentSince Mar 4, 2024 Accepting new patients
Boston University Family Medicine, Inc. Past Accepting new patients

Locations

950 Cambridge St
Cambridge, MA 02141
Phone (617) 441-1743

40 Church St
Fl 1
Lowell, MA 01852

40 Church St
Lowell, MA 01852
Phone (978) 458-6282

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.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1760631923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 JERSEY ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264915",
            "telephone_number": "617-640-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CHURCH ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018526113",
            "telephone_number": "978-674-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "358 E Javelina Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852106205",
            "country_code": "US",
            "telephone_number": "617-640-3857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Jersey St",
            "address_purpose": "LOCATION",
            "city": "Dedham",
            "state": "MA",
            "postal_code": "020264915",
            "country_code": "US",
            "telephone_number": "617-640-3857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIGUE",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "194285",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8053",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "194285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.