Individual provider Active NPI

Kristen T Proverb, MSN RN NPC

  • Critical Care Medicine Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1992867873
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
258630 Issued in MA
Practice address
222 Merrimack St
Suite 300
Lowell, MA 01852
Phone
(978) 454-0706
Fax
(978) 654-7978
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 258630 MA Primary

Addresses

Primary practice location

222 Merrimack St
Suite 300
Lowell, MA 01852

Mailing address

222 Merrimack St
Suite 300
Lowell, MA 01852
Phone (978) 454-0706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070115000191 MA Practitioner - Nurse Practitioner 0244230324 Reassigns benefits to 1 organization
I20200611001815 NH Practitioner - Nurse Practitioner 0244230324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Surgical Associates of Lowell, P.C.Group PAC ID 4880506484, 43 clinicians

Practice addresses (Care Compare)

14 Research PL
North Chelmsford, MA 01863-2460
Phone (978) 454-0706

Hospital & facility affiliations

  • Lowell General Hospital Hospital, Lowell, MA, CCN 220063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Surgical Associates of Lowell, P.C. CurrentSince Dec 11, 2006 Accepting new patients
Orthopaedic Surgical Associates of Lowell, P.C. CurrentSince Dec 11, 2006 Accepting new patients

Locations

222 Merrimack St
Ste 300
Lowell, MA 01852
Phone (617) 454-0706

14 Research Pl
North Chelmsford, MA 01863
Phone (978) 256-6607

41 Innovative Way
Nashua, NH 03062
Phone (603) 484-7710

23 Keewaydin Dr
Salem, NH 03079
Phone (603) 386-0272

Interoperability endpoints

  • Direct secure messaging: kristen.proverb.1@1154.direct.athenahealth.com

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.

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992867873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MERRIMACK ST",
            "address_2": "SUITE 300",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-454-0706",
            "fax_number": "978-654-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MERRIMACK ST",
            "address_2": "SUITE 300",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-454-0706",
            "fax_number": "978-654-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVERB",
        "first_name": "KRISTEN",
        "middle_name": "T",
        "credential": "MSN RN NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MA",
            "license": "258630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.