Active NPI
Mary Dolores Doherty, PEDIATRIC NURSE PRAC
- Pediatric Nurse Practitioner
- Boston, MA
National Provider Identifier
1871801233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN133659
- Practice address
- 243 Charles Street
Anesthesia Department
Boston, MA 02114 - Phone
- (617) 573-3380
- Fax
- (617) 573-4033
- NPI assigned
- Sep 20, 2010
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN133659 | MA | Primary |
Addresses
Primary practice location
243 Charles Street
Anesthesia Department
Boston, MA 02114
Mailing address
243 Charles Street
Massachusetts Eye & Ear Infirmary
Boston, MA 02114
Phone (617) 573-3380
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN133659 | MA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1871801233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 CHARLES STREET",
"address_2": "MASSACHUSETTS EYE & EAR INFIRMARY",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-573-3380",
"fax_number": "617-573-4033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CHARLES STREET",
"address_2": "ANESTHESIA DEPARTMENT",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-573-3380",
"fax_number": "617-573-4033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "MARY",
"middle_name": "DOLORES",
"credential": "PEDIATRIC NURSE PRAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "RN133659",
"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 Sep 20, 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.