NPIMap

Organization Active NPI

Fenway Health

  • Dental Clinic/Center
  • Boston, MA
National Provider Identifier
1124259056
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FENWAY HEALTH
Practice address
1340 Boylston St
Boston, MA 02215-4302
Phone
(617) 927-6127
NPI assigned
Jul 27, 2009
Last updated
Jul 27, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FENWAY COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Authorized official

Name
Ms. Kara Roberts
Title
Office Administrator
Phone
(617) 927-6479

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1340 Boylston St
Boston, MA 02215-4302

Mailing address

1340 Boylston Street
Boston, MA 02215
Phone (617) 927-6127

Other identifiers 1

IdentifierTypeStateIssuer
110020739BMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Fenway Community Health6 organizations share this tax ID, including this one
Part of
Fenway Community Health

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1124259056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-927-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-927-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENWAY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FENWAY COMMUNITY HEALTH CENTER",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "617-927-6479",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110020739B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.