Active NPI
Charles McGregor Troy II, PHD
- Clinical Social Worker
- Beverly, MA
National Provider Identifier
1043377625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 100579A
- Practice address
- 75 Herrick Street
Parkhurst Medical BLDG Suite 109
Beverly, MA 01915-5900 - Phone
- (978) 777-1546
- Fax
- (978) 777-1546
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 100579A | MA | Primary |
Addresses
Primary practice location
75 Herrick Street
Parkhurst Medical BLDG Suite 109
Beverly, MA 01915-5900
Mailing address
75 Herrick Street
Parkhurst Medical BLDG Suite 109
Beverly, MA 01915-5900
Phone (978) 777-1546
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01451 | Other | MA | BLUE CROSS BLUE SHIELD |
| 06350220 | Other | MA | MAGELLAN HEALTH PLAN |
| 718135 | Other | MA | TUFRS HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100579A | MA | MD | Clinical Social Worker |
| 100579 | MA | MD | Interpreter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043377625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 HERRICK STREET",
"address_2": "PARKHURST MEDICAL BLDG SUITE 109",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019155900",
"telephone_number": "978-777-1546",
"fax_number": "978-777-1546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 HERRICK STREET",
"address_2": "PARKHURST MEDICAL BLDG SUITE 109",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019155900",
"telephone_number": "978-777-1546",
"fax_number": "978-777-1546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROY",
"first_name": "CHARLES",
"middle_name": "MCGREGOR",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "100579A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P01451",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH PLAN",
"identifier": "06350220",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFRS HEALTH PLAN",
"identifier": "718135",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.