Organization Active NPI

South Shore Orthopaedic Specialists PC

  • Orthopaedic Surgery Physician
  • South Weymouth, MA
National Provider Identifier
1124191820
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTH SHORE ORTHOPAEDIC SPECIALISTS PC
Practice address
797 Main Street
South Weymouth, MA 02190
Phone
(781) 331-4450
Fax
(781) 335-6047
NPI assigned
Nov 17, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Owen R McConville, MD
Title
President
Phone
(781) 331-4450

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

797 Main Street
South Weymouth, MA 02190

Mailing address

797 Main Street
South Weymouth, MA 02190
Phone (781) 331-4450

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
9785531MedicaidMA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124191820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 MAIN STREET",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-331-4450",
            "fax_number": "781-335-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 MAIN STREET",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-331-4450",
            "fax_number": "781-335-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE ORTHOPAEDIC SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCONVILLE",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-331-4450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9785531",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, 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.