Active NPI
Anne Kennealey-McManus, NP, RN
- Clinical Nurse Specialist
- Boston, MA
National Provider Identifier
1811976749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 100002
- Practice address
- 1153 Centre St
Faulkner Breast Centre
Boston, MA 02130-3446 - Phone
- (617) 983-7773
- Fax
- (617) 983-7779
- NPI assigned
- Jan 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 100002 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Faulkner Breast Centre
Boston, MA 02130-3446
Mailing address
1153 Centre St
BWH-FH
Jamaica Plain, MA 02130-3446
Phone (617) 983-7179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0387100 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100002 | MA | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1811976749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "BWH-FH",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-7179",
"fax_number": "671-983-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "FAULKNER BREAST CENTRE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-7773",
"fax_number": "617-983-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEALEY-MCMANUS",
"first_name": "ANNE",
"credential": "NP, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "MA",
"license": "100002",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0387100",
"state": "MA"
}
],
"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 Feb 19, 2016; 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.