Individual provider Active NPI

Siri Mohr, ANP

  • Nurse Practitioner
  • Fairhaven, MA
National Provider Identifier
1912334186
Registry record updated Sep 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN250460 Issued in MA
Practice address
206 Mill Rd
Fairhaven, MA 02719-5208
Phone
(508) 973-3000
Fax
(508) 973-3119
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN250460 MA Primary

Addresses

Primary practice location

206 Mill Rd
Fairhaven, MA 02719-5208

Mailing address

200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smohr12964@direct.southcoast.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131223001076 MA Practitioner - Nurse Practitioner 3577790484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

206 Mill Rd
Fairhaven, MA 02719-5208
Phone (508) 973-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN250460MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Dec 23, 2013 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Dec 23, 2013 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

206 Mill Rd
Fairhaven, MA 02719
Phone (508) 973-3000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

506 Prospect St
Fall River, MA 02720
Phone (508) 973-7888

Interoperability endpoints

  • Direct secure messaging: smohr12964@direct.southcoast.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1912334186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195208",
            "telephone_number": "508-973-3000",
            "fax_number": "508-973-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "SIRI",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN250460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smohr12964@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "206 Mill Rd",
            "city": "Fairhaven",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027195208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.