Organization Active NPI

Lafayette Convalescent Home

  • Skilled Nursing Facility
  • Marblehead, MA
National Provider Identifier
1003803107
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0291 Issued in MA
Legal business name
LAFAYETTE CONVALESCENT HOME
Practice address
25 Lafayette St
Marblehead, MA 01945-1939
Phone
(781) 631-4535
Fax
(781) 631-6400
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Laura McDonnell
Title
Corporate Billing Manager
Phone
(978) 420-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0291 MA Primary

Addresses

Primary practice location

25 Lafayette St
Marblehead, MA 01945-1939

Mailing address

25 Lafayette St
Marblehead, MA 01945-1939
Phone (781) 631-4535

Other identifiers 1

IdentifierTypeStateIssuer
0918849MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003803107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LAFAYETTE ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451939",
            "telephone_number": "781-631-4535",
            "fax_number": "781-631-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LAFAYETTE ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451939",
            "telephone_number": "781-631-4535",
            "fax_number": "781-631-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE CONVALESCENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CORPORATE BILLING MANAGER",
        "authorized_official_telephone_number": "978-420-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0918849",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.