Individual provider Active NPI

Jacqueline Sue Myers, NP

  • Pediatric Nurse Practitioner
  • Hyannis, MA
National Provider Identifier
1861671513
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
109102 Issued in MA
Practice address
744 W Main St
BHS/School Based Health Center
Hyannis, MA 02601-3487
Phone
(508) 790-7200
Fax
(508) 790-3280
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 109102 MA Primary

Addresses

Primary practice location

744 W Main St
BHS/School Based Health Center
Hyannis, MA 02601-3487

Mailing address

744 W Main St
BHS/School Based Health Center
Hyannis, MA 02601-3487
Phone (508) 790-7200

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
109102MAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1861671513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MAIN ST",
            "address_2": "BHS/SCHOOL BASED HEALTH CENTER",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013487",
            "telephone_number": "508-790-7200",
            "fax_number": "508-790-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W MAIN ST",
            "address_2": "BHS/SCHOOL BASED HEALTH CENTER",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013487",
            "telephone_number": "508-790-7200",
            "fax_number": "508-790-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JACQUELINE",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "109102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.