Emerson Village, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMERSON VILLAGE, LLC

Doing business as

Emerson Village

Practice address

59 Coolidge Hill Rd
Watertown, MA 02472-2816

Phone

(617) 924-1130

Fax

(617) 924-5215

NPI assigned

Jan 22, 2008

Organization subpart

No

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

Authorized official

Name

Sean E. Durso

Title

Cfo

Phone

(617) 332-8481

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Emerson Village Doing business as

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1013194059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 COOLIDGE HILL RD",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722816",
            "telephone_number": "617-924-1130",
            "fax_number": "617-924-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 COOLIDGE HILL RD",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722816",
            "telephone_number": "617-924-1130",
            "fax_number": "617-924-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERSON VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "DURSO",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-332-8481"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0940518",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerson Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Watertown, MA
• Providers in Watertown, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.