Active NPI
Brenda Vigue
- Psychiatric/Mental Health Nurse Practitioner
- Lowell, MA
National Provider Identifier
1760631923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 194285
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050719000161 | MA | Practitioner - Nurse Practitioner | 7214964691 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP8053 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
| 194285 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vinfen Corporation | Current | 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.
-
- Community/Behavioral Health Agency
- Cambridge, MA
- NPI 1225168271
-
- Family Medicine Physician
- Boston, MA
- NPI 1134166390
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.