NPIMap

Organization Active NPI

VA Medical Center Brockton Ma

  • Psychiatric Hospital
  • Brockton, MA
National Provider Identifier
1104077544
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
233250 Issued in MA
Legal business name
VA MEDICAL CENTER BROCKTON MA
Practice address
25 Belmont CT Apt 8
Brockton, MA 02301-4730
Phone
(774) 826-2456
NPI assigned
Oct 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Mark Bauer
Title
Program Director
Phone
(774) 826-2456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 233250 MA Primary

Addresses

Primary practice location

25 Belmont CT Apt 8
Brockton, MA 02301-4730

Mailing address

25 Belmont CT Apt 8
Brockton, MA 02301-4730

National Provider Directory

National Provider Directory
Tax ID family
Didi Hirsch Mental Health Services140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1104077544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BELMONT CT APT 8",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BELMONT CT APT 8",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014730",
            "telephone_number": "774-826-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA MEDICAL CENTER BROCKTON MA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "774-826-2456"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MA",
            "license": "233250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.