JOHANNA MCDERMOTT NURSE PRACTITIONER NPI 1699101188

NPI Information

NPI: 1699101188
Provider Name: JOHANNA MCDERMOTT, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
119 BELMONT ST
WORCESTER, MA
ZIP 01605
Phone: (508) 334-6206
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Johanna Mcdermott, NURSE PRACTITIONER is a pediatrics nurse practitioner in Worcester, MA. Johanna Mcdermott, NURSE PRACTITIONER NPI is 1699101188. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

119 BELMONT ST
WORCESTER, MA
ZIP 01605
Phone: (508) 334-6206
Fax: (508) 334-6083

The NPI 1699101188 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/17/2013 and was last updated on 11/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	254292	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	254292	OTHER	MASSACHUSETTS	RN LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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