Individual provider Active NPI

Rebecca Kardon

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Worcester, MA
National Provider Identifier
1871530600
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
84306 Issued in MA
Practice address
26 Queen Street, Ground Floor
Umass Memorial Med Ctr, Ambulatory Psychiatry Service
Worcester, MA 01610
Phone
(508) 334-2537
Fax
(508) 334-4320
NPI assigned
Jun 1, 2006
Last updated
Oct 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 84306 MA Primary

Addresses

Primary practice location

26 Queen Street, Ground Floor
Umass Memorial Med Ctr, Ambulatory Psychiatry Service
Worcester, MA 01610

Mailing address

26 Queen Street, Ground Floor
Umass Memorial Med Ctr, Ambulatory Psychiatry Service
Worcester, MA 01610
Phone (508) 334-2537

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
84306MAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1871530600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET, GROUND FLOOR",
            "address_2": "UMASS MEMORIAL MED CTR, AMBULATORY PSYCHIATRY SERVICE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01610",
            "telephone_number": "508-334-2537",
            "fax_number": "508-334-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET, GROUND FLOOR",
            "address_2": "UMASS MEMORIAL MED CTR, AMBULATORY PSYCHIATRY SERVICE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01610",
            "telephone_number": "508-334-2537",
            "fax_number": "508-334-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDON",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "84306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.