Individual provider Active NPI

Kimberly Marie Dobbs

  • Mammography Radiologic Technologist
  • West Roxbury, MA
National Provider Identifier
1982926648
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Radiologic TechnologistTaxonomy code 2471M2300X
License
11852 Issued in MA
Practice address
30 Bellevue St
#7
West Roxbury, MA 02132-2639
Phone
(617) 922-7145
NPI assigned
Feb 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 11852 MA
Radiologic Technologist 247100000X 97756 CA
Radiologic Technologist 247100000X 399995 MA
Mammography Radiologic Technologist 2471M2300X 11852 MA Primary

Addresses

Primary practice location

30 Bellevue St
#7
West Roxbury, MA 02132-2639

Mailing address

30 Bellevue St
#7
West Roxbury, MA 02132-2639

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

LicenseStateTypeSpecialty
97756CAMDRadiologic Technologist
11852MAMDRadiologic Technologist
399995MAMDRadiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1982926648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BELLEVUE ST",
            "address_2": "#7",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BELLEVUE ST",
            "address_2": "#7",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322639",
            "telephone_number": "617-922-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBS",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MA",
            "license": "11852",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "97756",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MA",
            "license": "399995",
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Mammography",
            "state": "MA",
            "license": "11852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.