NPIMap

Organization Active NPI

Merrimack Valley Neurology LLC

  • Neurology Physician
  • North Andover, MA
National Provider Identifier
1023613726
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MERRIMACK VALLEY NEUROLOGY LLC
Practice address
200 Sutton St Ste 140
North Andover, MA 01845-1651
Phone
(978) 620-8444
NPI assigned
Dec 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Steven Smith, CREDENTIALING
Title
Manager
Phone
(502) 244-9859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

200 Sutton St Ste 140
North Andover, MA 01845-1651

Mailing address

200 Sutton St Ste 140
North Andover, MA 01845-1651
Phone (978) 620-8444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210104000149 MA Part B Supplier - Clinic/Group Practice 1658784046 Receives reassigned benefits from 1 practitioner
Practice locations: Dracut, MA; North Andover, MA

National Provider Directory

National Provider Directory
Tax ID family
Merrimack Valley Neurology LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1023613726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SUTTON ST STE 140",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451651",
            "telephone_number": "978-620-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SUTTON ST STE 140",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451651",
            "telephone_number": "978-620-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK VALLEY NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-244-9859",
        "authorized_official_credential": "CREDENTIALING"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.