Active NPI
MGH
Doing business as Us navy
- Exclusive Provider Organization
- Beverly, MA
National Provider Identifier
1063716579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- License
- 179866
- Legal business name
- MGH
- Doing business as
- Us navy
- Practice address
- 10 Tall Tree Dr
Beverly, MA 01915-2012 - Phone
- (978) 979-7410
- NPI assigned
- Dec 28, 2010
- Organization subpart
- Yes
- Parent organization
- MG17508
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lynne Brodsky, MD
- Title
- MD
- Phone
- (617) 889-8580
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chronic Disease Hospital | 281P00000X | 179866 | MA | |
| Exclusive Provider Organization | 302F00000X | 179866 | MA | Primary |
Addresses
Primary practice location
10 Tall Tree Dr
Beverly, MA 01915-2012
Mailing address
10 Tall Tree Drive
Beverly, MA 01915
Phone (978) 979-7410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003910548 | Other | MA | NPI |
Other names 1
- Us navy
National Provider Directory
National Provider Directory- Part of
- Renal Associates
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Psychiatric/Mental Health Registered Nurse
- Bethesda, MD
- NPI 1003910548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1293494400000",
"number": "1063716579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 TALL TREE DRIVE",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-979-7410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 TALL TREE DR",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019152012",
"telephone_number": "978-979-7410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MGH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MG17508",
"enumeration_date": "2010-12-28",
"last_updated": "2010-12-28",
"status": "A",
"authorized_official_last_name": "BRODSKY",
"authorized_official_first_name": "LYNNE",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "617-889-8580",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "281P00000X",
"taxonomy_group": "",
"desc": "Chronic Disease Hospital",
"state": "MA",
"license": "179866",
"primary": false
},
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "MA",
"license": "179866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1003910548",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Us navy",
"code": "3",
"type": "Doing Business As"
}
]
}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 Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.