Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Taylor Johnson Antonellis, FNP-C

Individual provider Family Nurse Practitioner · NPI 1144957036

Taylor Johnson Antonellis, FNP-C is a Nurse Practitioner in Waltham, Massachusetts. Qualified in 2022, 4 years ago. Practices with Charles River Community Health, Inc, a 33-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
4
Licensed in
MA
In the registry since
2022
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

43 Foundry Ave Ste 110
Waltham, MA 02453-8313
Phone: (781) 693-3800
Fax: (617) 562-1398
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN2350068 (MA)

Record details

NPI number1144957036
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedAugust 2, 2022
Last updated in NPPESApril 10, 2026
Certification dateApril 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Charles River Community Health, Inc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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