Individual provider Active NPI

Lawrence M Kulla

  • Specialist
  • South Weymouth, MA
National Provider Identifier
1952365264
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
45807 Issued in MA
Practice address
851 Main St
Suite 11
South Weymouth, MA 02190-1612
Phone
(781) 331-4923
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 45807 MA Primary

Addresses

Primary practice location

851 Main St
Suite 11
South Weymouth, MA 02190-1612

Mailing address

32 Mason Rd
Newton, MA 02459-1506
Phone (617) 244-2007

Other identifiers 1

IdentifierTypeStateIssuer
9734643MedicaidMA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1952365264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 MASON RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024591506",
            "telephone_number": "617-244-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "address_2": "SUITE 11",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901612",
            "telephone_number": "781-331-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLA",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "45807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9734643",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.