1801833488 NPI number — JENNIFER H LADNER MD

Table of content: JENNIFER H LADNER MD (NPI 1801833488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801833488 NPI number — JENNIFER H LADNER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LADNER
Provider First Name:
JENNIFER
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801833488
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 TER HEUN DRIVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-540-0604
Provider Business Mailing Address Fax Number:
508-457-0129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 TER HEUN DRIVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-540-0604
Provider Business Practice Location Address Fax Number:
508-457-0129
Provider Enumeration Date:
06/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  218613 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2017032 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043488655 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 218613 . This is a "MA LICENSE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J26732 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10725539 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1801833488 . This is a "UNICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1801833488 . This is a "GREAT WEST HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 467287 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: ML0524492A . This is a "MA CDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3268298 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1801833488 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: LAA35789 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0038770 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1554097001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 304922 . This is a "HPH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000029656 . This is a "BOSTON MEDICAL CENTER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043488655 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00050045 . This is a "MEDICARE ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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