NPIMap

Organization Active NPI

Children'S Services of Roxbury, Inc.

  • Community/Behavioral Health Agency
  • Roxbury, MA
National Provider Identifier
1124253794
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHILDREN'S SERVICES OF ROXBURY, INC.
Practice address
520 Dudley St
Roxbury, MA 02119-2769
Phone
(617) 445-6655
Fax
(617) 445-0940
NPI assigned
May 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Authorized official

Name
Ms. Pamela A Ogletree
Title
President and Ceo
Phone
(617) 445-6655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

520 Dudley St
Roxbury, MA 02119-2769

Mailing address

520 Dudley St
Roxbury, MA 02119-2769
Phone (617) 445-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151103001593 MA Part B Supplier - Clinic/Group Practice 5193035178 Receives reassigned benefits from 1 practitioner
Practice locations: Roxbury, MA

National Provider Directory

National Provider Directory
Tax ID family
Children Services of Roxbury5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1124253794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 DUDLEY ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192769",
            "telephone_number": "617-445-6655",
            "fax_number": "617-445-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 DUDLEY ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192769",
            "telephone_number": "617-445-6655",
            "fax_number": "617-445-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S SERVICES OF ROXBURY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "OGLETREE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "617-445-6655",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.