Individual provider Active NPI

Kathleen Marcoux

  • Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1972040236
Registry record updated May 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2311346 Issued in MA
Practice address
161 Jackson St
Lowell, MA 01852-2103
Phone
(978) 937-9700
NPI assigned
Jan 25, 2017
Last updated
May 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2311346 MA
Nurse Practitioner 363L00000X RN2311346 MA Primary

Addresses

Primary practice location

161 Jackson St
Lowell, MA 01852-2103

Mailing address

161 Jackson St
Lowell, MA 01852-2103

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
I20200526002852 MA Practitioner - Nurse Practitioner 9931520178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2311346MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Lowell Community Health Center, Inc. Current Accepting new patients

Locations

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

Interoperability endpoints

  • Direct secure messaging: kmarcoux20044@direct.ctc.masshiway.net

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.

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590364800000",
    "number": "1972040236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103",
            "telephone_number": "978-937-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOUX",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2311346",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2311346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.