Individual provider Active NPI

Adam Popp

  • Psychiatric/Mental Health Nurse Practitioner
  • Norwell, MA
National Provider Identifier
1932956190
Registry record updated Jan 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2379255 Issued in MA
Practice address
200 Cordwainer Dr # 304
Norwell, MA 02061-1671
Phone
(781) 546-2968
NPI assigned
May 3, 2024
Last updated
Jan 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F406355 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2379255 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Registered Nurse 163W00000X RN2379255 MA
Registered Nurse 163W00000X 953211 NY

Addresses

Primary practice location

200 Cordwainer Dr # 304
Norwell, MA 02061-1671

Mailing address

200 Cordwainer Dr # 304
Norwell, MA 02061-1671

Other practice location 1

11 Broadway Ste 930
New York, NY 10004-1350
Phone (212) 320-2216

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
I20260115001365 MA Practitioner - Nurse Practitioner 1658857099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kim Psychiatric ServicesGroup PAC ID 2466801543, 5 clinicians

Practice addresses (Care Compare)

200 Cordwainer Dr
Suite 304
Norwell, MA 02061-1671
Phone (781) 546-8368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2379255MAMDRegistered Nurse
953211NYMDRegistered Nurse
F406355NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Psychiatry and Integrated Medicine Center CurrentSince Sep 14, 2025 Accepting new patients
Kim Psychiatric Services CurrentSince Dec 9, 2025 Accepting new patients
Daniel J. Zimmerman, M.D., Psychiatry Services, PLLC PastSince Jan 4, 2026 Accepting new patients

Locations

200 Cordwainer Dr
#304
Norwell, MA 02061
Phone (781) 546-2968

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767484800000",
    "number": "1932956190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR # 304",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR # 304",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671",
            "telephone_number": "781-546-2968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Broadway Ste 930",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100041350",
            "country_code": "US",
            "telephone_number": "212-320-2216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPP",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-03",
        "last_updated": "2026-01-04",
        "certification_date": "2026-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F406355",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2379255",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2379255",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "953211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.