NPIMap

Organization Active NPI

Neurosportelite North Boston, LLC

  • Health Service Clinic/Center
  • Woburn, MA
National Provider Identifier
1043757115
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
3375 Issued in MA
Legal business name
NEUROSPORTELITE NORTH BOSTON, LLC
Practice address
78 Olympia Ave
Woburn, MA 01801-2057
Phone
(608) 988-8088
Fax
(888) 456-2475
NPI assigned
Jan 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Authorized official

Name
Dr. Spencer Howard Baron, DC
Title
President
Phone
(954) 800-5017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 3375 MA Primary

Addresses

Primary practice location

78 Olympia Ave
Woburn, MA 01801-2057

Mailing address

78 Olympia Ave
Woburn, MA 01801-2057
Phone (603) 988-8088

National Provider Directory

National Provider Directory

Locations

78 Olympia Ave
Woburn, MA 01801
Phone (608) 988-8088

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1043757115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 OLYMPIA AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012057",
            "telephone_number": "603-988-8088",
            "fax_number": "888-456-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 OLYMPIA AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012057",
            "telephone_number": "608-988-8088",
            "fax_number": "888-456-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSPORTELITE NORTH BOSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "BARON",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-800-5017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MA",
            "license": "3375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.