Berkshire Colon & Rectal Surgery, LLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

BERKSHIRE COLON & RECTAL SURGERY, LLC

Practice address

777 North St
Suite 605
Pittsfield, MA 01201-4147

Phone

(413) 447-2859

Fax

(413) 346-6703

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marcella W. Bradway, M.D.

Title

Owner

Phone

(413) 447-2859

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1043475932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 RIDGE AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014147",
            "telephone_number": "413-447-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NORTH ST",
            "address_2": "SUITE 605",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014147",
            "telephone_number": "413-447-2859",
            "fax_number": "413-346-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKSHIRE COLON & RECTAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "BRADWAY",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-447-2859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "D04850",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Colon & Rectal Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.