Urgent Care of Medford, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

URGENT CARE OF MEDFORD, LLC

Practice address

4110 Mystic Valley Pkwy
Suite 2
Medford, MA 02155-6931

Phone

(781) 874-9399

Fax

(781) 874-9275

NPI assigned

Dec 7, 2016

Organization subpart

No

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

Authorized official

Name

Jeannie Kenkare, DO

Title

Managing Partner/Cmo

Phone

(203) 616-4440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1053855247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 MAIN ST",
            "address_2": "SUITE 101",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331007",
            "telephone_number": "860-430-1246",
            "fax_number": "203-905-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 MYSTIC VALLEY PKWY",
            "address_2": "SUITE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556931",
            "telephone_number": "781-874-9399",
            "fax_number": "781-874-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE OF MEDFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "KENKARE",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_title_or_position": "MANAGING PARTNER/CMO",
        "authorized_official_telephone_number": "203-616-4440",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tufts Medicine Pharmacy LLC
• Tufts University Health Service
• Marie Edna Ulysse
• Union Square Physical Therapy LLC. (Medford Physical Therapy)
• Antonia M Urdi
• Chantal Valentin, RN
• David Valenza
• Liana Kim Van de Water
• Srilekha Mahi Vangala
• Amy Lee Velez

• Urgent Care Clinic/Center in Medford, MA
• Providers in Medford, MA by specialty
• Urgent Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.