NPIMap

Organization Active NPI

Fenway Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Boston, MA
National Provider Identifier
1073744611
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FENWAY COMMUNITY HEALTH CENTER, INC
Practice address
1340 Boylston St
6TH Floor
Boston, MA 02215-4302
Phone
(617) 927-6479
Fax
(617) 927-6150
NPI assigned
Jul 30, 2009
Last updated
Jul 30, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FENWAY HEALTH OPTOMETRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Authorized official

Name
Ms. Kara Roberts
Title
Administrative Manager
Phone
(617) 927-6479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1340 Boylston St
6TH Floor
Boston, MA 02215-4302

Mailing address

1340 Boylston St
6TH Floor
Boston, MA 02215-4302
Phone (617) 927-6479

Other identifiers 1

IdentifierTypeStateIssuer
110020739BMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Fenway Coummunity Healt6 organizations share this tax ID, including this one
Part of
Fenway Coummunity Healt

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1340 Boylston St
Fl 6
Boston, MA 02215
Phone (617) 927-6479

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1073744611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "address_2": "6TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-927-6479",
            "fax_number": "617-927-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "address_2": "6TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-927-6479",
            "fax_number": "617-927-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENWAY COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FENWAY HEALTH OPTOMETRY",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAGER",
        "authorized_official_telephone_number": "617-927-6479",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110020739B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.