Active NPI
Scituatelight Primary Care Services
- Primary Care Nurse Practitioner
- Stoughton, MA
National Provider Identifier
1962077362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- SCITUATELIGHT PRIMARY CARE SERVICES
- Practice address
- 630 Park St
Stoughton, MA 02072-3659 - Phone
- (508) 345-9420
- NPI assigned
- May 26, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Esther Wamburu
- Title
- Owner
- Phone
- (508) 436-3432
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
630 Park St
Stoughton, MA 02072-3659
Mailing address
966 Park St
Stoughton, MA 02072-3650
Phone (781) 436-8418
Other names 1
- Scituatelight Primary Care Services
National Provider Directory
National Provider DirectoryLocations
966 Park St
Stoughton, MA 02072
Phone (617) 344-4084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706745600000",
"number": "1962077362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "966 PARK ST",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020723650",
"telephone_number": "781-436-8418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 PARK ST",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020723659",
"telephone_number": "508-345-9420"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCITUATELIGHT PRIMARY CARE SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-26",
"last_updated": "2024-02-01",
"certification_date": "2024-01-31",
"status": "A",
"authorized_official_last_name": "WAMBURU",
"authorized_official_first_name": "ESTHER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "508-436-3432"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Scituatelight Primary Care Services",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Stoughton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.