NPIMap

Organization Active NPI

Instride Health Ma PC

  • Adolescent and Children Mental Health Clinic/Center
  • Wellesley Hills, MA
National Provider Identifier
1124791439
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
INSTRIDE HEALTH MA PC
Practice address
396 Washington St # 266
Wellesley Hills, MA 02481-6209
Phone
(855) 438-8331
NPI assigned
Aug 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Dr. Mona Potter, MDNPI 1235113010
Title
Chief Medical Officer
Phone
(615) 424-3398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

396 Washington St # 266
Wellesley Hills, MA 02481-6209

Mailing address

5 Locke LN
Lexington, MA 02420-2706
Phone (615) 424-3398

Other practice location 1

67 Burnside Ave
Hartford, CT 06108-3408
Phone (855) 438-8331

Other practice location 2

2 1/2 Beacon St
Concord, NH 03301-4447
Phone (855) 438-8331

Other practice location 3

450 Veterans Memorial Pkwy Ste 7A
East Providence, RI 02914-5315
Phone (855) 438-8331

Other names 1

  • Etude Health MA PC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1627776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1124791439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LOCKE LN",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024202706",
            "telephone_number": "615-424-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 WASHINGTON ST # 266",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024816209",
            "telephone_number": "855-438-8331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Burnside Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061083408",
            "country_code": "US",
            "telephone_number": "855-438-8331",
            "fax_number": "617-928-8649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 1/2 Beacon St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033014447",
            "country_code": "US",
            "telephone_number": "855-438-8331",
            "fax_number": "617-928-8649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Veterans Memorial Pkwy Ste 7A",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029145315",
            "country_code": "US",
            "telephone_number": "855-438-8331",
            "fax_number": "617-928-8649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INSTRIDE HEALTH MA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-01",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "615-424-3398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Etude Health MA PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Etude Health MA PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wellesley Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.