Organization Active NPI

Somerville Home, Inc.

  • Nursing Facility/Intermediate Care Facility
  • Somerville, MA
National Provider Identifier
1033199476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
1375 Issued in MA
Legal business name
SOMERVILLE HOME, INC.
Practice address
117 Summer St
Somerville, MA 02143-2706
Phone
(617) 776-0260
Fax
(617) 628-9721
NPI assigned
Jan 20, 2006
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. Alyson L. Toole
Title
Administrator
Phone
(617) 776-0260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 1375 MA Primary

Addresses

Primary practice location

117 Summer St
Somerville, MA 02143-2706

Mailing address

117 Summer St
Somerville, MA 02143-2706
Phone (617) 776-0260

Other identifiers 1

IdentifierTypeStateIssuer
5503272MedicaidMA

National Provider Directory

National Provider Directory

Locations

117 Summer St
Somerville, MA 02143
Phone (617) 284-5130

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033199476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SUMMER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432706",
            "telephone_number": "617-776-0260",
            "fax_number": "617-628-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SUMMER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432706",
            "telephone_number": "617-776-0260",
            "fax_number": "617-628-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOOLE",
        "authorized_official_first_name": "ALYSON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-776-0260",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MA",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5503272",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, 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.