NPIMap

Organization Active NPI

St. Luke's Home

  • Adult Care Home Facility
  • Springfield, MA
National Provider Identifier
1124019393
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
863 Issued in MA
Legal business name
ST. LUKE'S HOME
Practice address
85 Spring St
Springfield, MA 01105-1211
Phone
(413) 736-5494
Fax
(413) 746-5075
NPI assigned
Nov 4, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cynthia A Brown
Title
Administrator
Phone
(413) 736-5494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 863 MA Primary

Addresses

Primary practice location

85 Spring St
Springfield, MA 01105-1211

Mailing address

85 Spring St
Springfield, MA 01105-1211
Phone (413) 736-5494

Other identifiers 1

IdentifierTypeStateIssuer
5508312MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Beaven Kelly Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

85 Spring St
Springfield, MA 01105
Phone (413) 496-0701

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124019393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SPRING ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051211",
            "telephone_number": "413-736-5494",
            "fax_number": "413-746-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SPRING ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051211",
            "telephone_number": "413-736-5494",
            "fax_number": "413-746-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "413-736-5494",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MA",
            "license": "863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508312",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.