NPIMap

Organization Active NPI

Coordinated Primary Care

  • Neurology Physician
  • Leominster, MA
National Provider Identifier
1104880673
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
COORDINATED PRIMARY CARE
Practice address
50 Memorial Drive
Suite 211
Leominster, MA 01453
Phone
(978) 466-2411
Fax
(978) 537-9211
NPI assigned
Apr 13, 2006
Organization subpart
Yes
Parent organization
COORDINATED PRIMARY CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Phyllis Fabello
Title
Director CPC
Phone
(978) 466-4243

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X MA Primary

Addresses

Primary practice location

50 Memorial Drive
Suite 211
Leominster, MA 01453

Mailing address

50 Memorial Drive
Suite 211
Leominster, MA 01453
Phone (978) 466-2411

Other identifiers 1

IdentifierTypeStateIssuer
9771476MedicaidMA

Other names 1

  • HealthAlliance Neurology Doing business as

National Provider Directory

National Provider Directory
Part of
Coordinated Primary Care Inc

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1104880673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 211",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2411",
            "fax_number": "978-537-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 211",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2411",
            "fax_number": "978-537-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COORDINATED PRIMARY CARE",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "FABELLO",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "DIRECTOR CPC",
        "authorized_official_telephone_number": "978-466-4243"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9771476",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthAlliance Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.