Active NPI
Maxwell Dede
- Licensed Practical Nurse
- Lynn, MA
National Provider Identifier
1942520101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LN65112
- Practice address
- 11 Bellevue Rd
2ND Floor
Lynn, MA 01904-2807 - Phone
- (781) 595-0311
- NPI assigned
- Jun 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LN65112 | MA | Primary |
| Nurse's Aide | 376K00000X | LN65112 | MA |
Addresses
Primary practice location
11 Bellevue Rd
2ND Floor
Lynn, MA 01904-2807
Mailing address
11 Bellevue Rd
2ND Floor
Lynn, MA 01904-2807
Phone (781) 595-0311
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 |
|---|---|---|---|
| LN65112 | MA | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Wellness Care LLC | Current | Accepting new patients | |
| Patient Care Solutions LLC | Current | Accepting new patients |
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.
-
- In Home Supportive Care Agency
- Danvers, MA
- NPI 1437930781
-
- Home Health Agency
- Lynn, MA
- NPI 1407121981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1942520101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BELLEVUE RD",
"address_2": "2ND FLOOR",
"city": "LYNN",
"state": "MA",
"postal_code": "019042807",
"telephone_number": "781-595-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 BELLEVUE RD",
"address_2": "2ND FLOOR",
"city": "LYNN",
"state": "MA",
"postal_code": "019042807",
"telephone_number": "781-595-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDE",
"first_name": "MAXWELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-09",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MA",
"license": "LN65112",
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MA",
"license": "LN65112",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.