Meredith Brassard Detwiler, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

268698 Issued in MA

Practice address

105 Webster St Ste 8
Hanover, MA 02339-1227

Phone

(781) 754-6545

Fax

(781) 536-0016

NPI assigned

Feb 25, 2009

Last updated

Jun 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Pinnacle Health Management LLPGroup PAC ID 7214974708, 18 clinicians

Lighthouse Mental Wellness PLLCGroup PAC ID 5698206324, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lighthouse Mental Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pembroke, MA
  • NPI 1821564790
  Medicare reassignment Care Compare group NPD
• Pinnacle Health Management, LLP

  • Geriatric Psychiatry Physician
  • Hanover, MA
  • NPI 1952319733
  Medicare reassignment Care Compare group NPD
• Golden Insight Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Hanover, MA
  • NPI 1235711839
  NPD

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1881834174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEBSTER ST STE 8",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391227",
            "telephone_number": "781-754-6545",
            "fax_number": "781-536-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEBSTER ST STE 8",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391227",
            "telephone_number": "781-754-6545",
            "fax_number": "781-536-0016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Riverside Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Pembroke",
            "state": "MA",
            "postal_code": "023594947",
            "country_code": "US",
            "telephone_number": "781-427-7070 x1",
            "fax_number": "781-427-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "MEREDITH",
        "middle_name": "BRASSARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "268698",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "268698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110091419A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irina Dauphinee, PMHNP, FNP
• Grace Davis, LCSW
• Delia Fox D.B.a. Delias Wigs & Coiffures, Inc
• Agnes Geralyn Densmore, CNM
• Dentists of Hanover, PC (Dentists of Hanover)
• Kelly Dibenedetto, LMHC
• Mark Edward Donelan, D.M.D.
• Donnelly Orthodontics, Inc
• Emily Doolin
• Kathryn Doran, SLP

• Psychiatric/Mental Health Nurse Practitioner in Hanover, MA
• Providers in Hanover, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.