NPIMap

Organization Active NPI

Merrimack Family Medicine PC

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1033392022
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49826 Issued in MA
Legal business name
MERRIMACK FAMILY MEDICINE PC
Practice address
170 Main Street
Suite 606
Tewksbury, MA 01876
Phone
(978) 851-4141
NPI assigned
Dec 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Donald H Miller, MDNPI 1922079219
Title
President
Phone
(978) 851-4141

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 49826 MA Primary

Addresses

Primary practice location

170 Main Street
Suite 606
Tewksbury, MA 01876

Mailing address

170 Main Street
Suite 606
Tewksbury, MA 01876
Phone (978) 851-4141

Other identifiers 1

IdentifierTypeStateIssuer
9763473MedicaidMA

National Provider Directory

National Provider Directory

Locations

170 Main St
Ste 606
Tewksbury, MA 01876
Phone (978) 851-4141

170 Main St
Unit G06
Tewksbury, MA 01876
Phone (978) 851-4141

Practitioners & affiliated clinicians

Practitioners 6

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": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1033392022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MAIN STREET",
            "address_2": "SUITE 606",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-851-4141",
            "fax_number": "978-640-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MAIN STREET",
            "address_2": "SUITE 606",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-851-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-851-4141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "49826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9763473",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.