NPIMap

Organization Active NPI

Functional Psychiatry and Integrated Medicine Center

  • Psychiatry Physician
  • Norwell, MA
National Provider Identifier
1013898501
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FUNCTIONAL PSYCHIATRY AND INTEGRATED MEDICINE CENTER
Practice address
200 Cordwainer Dr # 304
Norwell, MA 02061-1671
Phone
(781) 546-2968
NPI assigned
Sep 10, 2025
Last updated
Sep 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Jessica KimNPI 1487053328
Title
Director
Phone
(201) 328-2331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

200 Cordwainer Dr # 304
Norwell, MA 02061-1671

Mailing address

200 Cordwainer Dr # 304
Norwell, MA 02061-1671

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1013898501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR # 304",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR # 304",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671",
            "telephone_number": "781-546-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PSYCHIATRY AND INTEGRATED MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-328-2331"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.