Active NPI
Registered Nurse Agency
- Nursing Facility/Intermediate Care Facility
- Boston, MA
National Provider Identifier
1780005330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 2268310
- Legal business name
- REGISTERED NURSE AGENCY
- Practice address
- 580 Shawmut Ave
Apt 1a
Boston, MA 02118-1775 - Phone
- (617) 275-9385
- NPI assigned
- Dec 30, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Nosayaba Esther Izedonmwen, RN
- Title
- Registered Nurse
- Phone
- (617) 275-9385
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 2268310 | MA | Primary |
Addresses
Primary practice location
580 Shawmut Ave
Apt 1a
Boston, MA 02118-1775
Mailing address
580 Shawmut Ave Apt 1a
Boston, MA 02118-1775
Phone (617) 275-9385
Other names 1
- NA
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1388361600000",
"number": "1780005330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 SHAWMUT AVE APT 1A",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181775",
"telephone_number": "617-275-9385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 SHAWMUT AVE",
"address_2": "APT 1A",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181775",
"telephone_number": "617-275-9385"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGISTERED NURSE AGENCY",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-30",
"last_updated": "2013-12-30",
"status": "A",
"authorized_official_last_name": "IZEDONMWEN",
"authorized_official_first_name": "NOSAYABA",
"authorized_official_middle_name": "ESTHER",
"authorized_official_title_or_position": "REGISTERED NURSE",
"authorized_official_telephone_number": "617-275-9385",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "MA",
"license": "2268310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "NA",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.