Individual provider Active NPI

Deborah Dornon Navedo, NP, APRN

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1821510850
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
240888-NP Issued in MA
Practice address
36 1St Ave
Boston, MA 02129-4557
Phone
(617) 643-4899
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 240888-NP MA Primary
Emergency Registered Nurse 163WE0003X 240888 MA

Addresses

Primary practice location

36 1St Ave
Boston, MA 02129-4557

Mailing address

363 S Huntington Ave Apt 3
Jamaica Plain, MA 02130-4822
Phone (774) 210-0112

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
240888MAMDEmergency Registered Nurse
240888-NPMAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1821510850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 S HUNTINGTON AVE APT 3",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304822",
            "telephone_number": "774-210-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 1ST AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021294557",
            "telephone_number": "617-643-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVEDO",
        "first_name": "DEBORAH",
        "middle_name": "DORNON",
        "credential": "NP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "240888-NP",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MA",
            "license": "240888",
            "primary": false
        }
    ],
    "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 Jul 12, 2017; 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.