Individual provider Active NPI

Kathleen M Scanlon, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1811214463
Registry record updated Apr 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
132761 Issued in MA
Practice address
1 Boston Medical Center Place
Boston Medical Center-
Boston, MA 02118
Phone
(617) 638-8497
NPI assigned
Apr 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 132761 MA Primary

Addresses

Primary practice location

1 Boston Medical Center Place
Boston Medical Center-
Boston, MA 02118

Mailing address

1 Adams St
Ste 703
Quincy, MA 02169-2000
Phone (617) 770-9988

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

State licenses

LicenseStateTypeSpecialty
132761MAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271894400000",
    "number": "1811214463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ADAMS ST",
            "address_2": "STE 703",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692000",
            "telephone_number": "617-770-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CENTER PLACE",
            "address_2": "BOSTON MEDICAL CENTER-",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "132761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 22, 2010; 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.