Active NPI
Sera Ann Genovese, R.N.
- Registered Nurse
- Brockton, MA
National Provider Identifier
1770747396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 281793
- Practice address
- 1115 W Chestnut St
Brockton, MA 02301-7501 - Phone
- (508) 559-0473
- Fax
- (508) 427-5361
- NPI assigned
- Jul 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 281793 | MA | Primary |
Addresses
Primary practice location
1115 W Chestnut St
Brockton, MA 02301-7501
Mailing address
86 Howe Rd
Cohasset, MA 02025-1033
Phone (781) 383-2839
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 281793 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215907200000",
"number": "1770747396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 HOWE RD",
"city": "COHASSET",
"state": "MA",
"postal_code": "020251033",
"telephone_number": "781-383-2839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-559-0473",
"fax_number": "508-427-5361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENOVESE",
"first_name": "SERA",
"middle_name": "ANN",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-13",
"last_updated": "2008-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "281793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.