Active NPI
Careteam Health SC PC
- Family Medicine Physician
- Watertown, MA
National Provider Identifier
1104491984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CARETEAM HEALTH SC PC
- Doing business as
- CareTeam Corporate Health: Watertown
- Practice address
- 311 Arsenal St
Watertown, MA 02472-2782 - Phone
- (617) 402-2157
- NPI assigned
- May 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew Theodore
- Title
- Director of Operations
- Phone
- (843) 729-0316
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
311 Arsenal St
Watertown, MA 02472-2782
Mailing address
PO Box 1875
Mt Pleasant, SC 29465-1875
Phone (843) 371-1471
Other names 1
- CareTeam Corporate Health: Watertown
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://api.platform.athenahealth.com/23914/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621814400000",
"number": "1104491984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1875",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294651875",
"telephone_number": "843-371-1471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 ARSENAL ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024722782",
"telephone_number": "617-402-2157"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARETEAM HEALTH SC PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-24",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A",
"authorized_official_last_name": "THEODORE",
"authorized_official_first_name": "MATTHEW",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "843-729-0316"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CareTeam Corporate Health: Watertown",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.