Organization Active NPI

Registered Nurse Agency

  • Nursing Facility/Intermediate Care Facility
  • Boston, MA
National Provider Identifier
1780005330
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
2268310 Issued in MA
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

Updated by the provider on Dec 30, 2013

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)CodeLicenseStatePrimary
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 Other name

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.