NPIMap

Organization Active NPI

McFadden Memorial Manor

  • Nursing Facility/Intermediate Care Facility
  • Malden, MA
National Provider Identifier
1003943515
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0686 Issued in MA
Legal business name
MCFADDEN MEMORIAL MANOR
Practice address
341 Forest St
Malden, MA 02148-1604
Phone
(781) 322-1700
Fax
(781) 397-7375
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Gary Richard Dixon
Title
Director
Phone
(781) 322-1701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0686 MA Primary

Addresses

Primary practice location

341 Forest St
Malden, MA 02148-1604

Mailing address

341 Forest St
Malden, MA 02148-1604
Phone (781) 322-1700

Other identifiers 1

IdentifierTypeStateIssuer
0907731MedicaidMA

Other names 1

  • City of Malden Other name

National Provider Directory

National Provider Directory
Tax ID family
City of Malden5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1003943515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 FOREST ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021481604",
            "telephone_number": "781-322-1700",
            "fax_number": "781-397-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 FOREST ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021481604",
            "telephone_number": "781-322-1700",
            "fax_number": "781-397-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCFADDEN MEMORIAL MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "781-322-1701"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MA",
            "license": "0686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0907731",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Malden",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.