KIM BEAUDRY (NPI# 1083253355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083253355 |
| Entity Type | Individual |
| Full Name | KIM BEAUDRY |
| Credential | NP |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
329 Conway St Ste 2 Greenfield MA 01301-1522 |
| Practice Telephone | 7744416605 |
| Mailing Telephone | 4137742400 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
156137 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205334588 | Mary Torkornoo | Nurse Practitioner | 430 Massasoit Rd, Worcester, MA 01604-3546 | 2018-01-31 |
| 1306490396 | Tara L Deso | Nurse Practitioner | 385 Grove St, Worcester, MA 01605-3924 | 2019-07-29 |
| 1659732022 | Susan M. Mugford | Nurse Practitioner | 630 Plantation St, Worcester, MA 01605-2038 | 2016-03-14 |
| 1376927400 | Jennifer A. Stanhope | Nurse Practitioner | 630 Plantation St, Worcester, MA 01605-2038 | 2015-07-18 |
| 1649527037 | Krista Marshall | Nurse Practitioner | 277 E Mountain St, Worcester, MA 01606-1207 | 2012-08-06 |
| 1447366489 | Helen D. Gilbert | Nurse Practitioner | 72 Jaques Ave, Worcester, MA 01610-2476 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018370 | Ashley Erin Dimauro | Nurse Practitioner | 155 Federal St Ste 700, Boston, MA 02110-1727 | 2019-11-18 |
| 1780228924 | Jeffrey J Benoit | Nurse Practitioner | 103 Upper Rd, Deerfield, MA 01342-9739 | 2019-10-31 |
| 1962064626 | Katharine Kingsley Campbell | Nurse Practitioner | 50 Orchardhill Rd, Jamaica Plain, MA 02130-3725 | 2019-07-02 |
| 1124502737 | Rebecca Gaffney | Nurse Practitioner | 200 Mill Rd Ste 190, Fairhaven, MA 02719-5259 | 2018-09-19 |
| 1154821114 | Caroline Namuzinda Mawanda | Nurse Practitioner | 8 Baron Park Ln Apt 20, Burlington, MA 01803-5453 | 2018-02-16 |
| 1508374406 | Kristin Tyrrell Chouinard | Nurse Practitioner | Home Md, 75 Sylvan St., Danvers, MA 01923-0192 | 2018-01-14 |
| 1962921379 | Krysta L Doucette | Nurse Practitioner | 47 High Street Suite 101, North Andover, MA 01845-5201 | 2017-09-18 |
| 1366961310 | Christine Anna Corallino | Nurse Practitioner | 14 Foster Street, #3, Boston, MA 02109 | 2017-09-11 |
| 1922546407 | Lisa Marie Joyce | Nurse Practitioner | 321 Manley St, West Bridgewater, MA 02379 | 2017-02-06 |
| 1891232906 | Stella Uchendu | Nurse Practitioner | 127 Grove St, Lynn, MA 01905-1615 | 2017-01-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.