Needham Nursing LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0986 Issued in MA

Legal business name

NEEDHAM NURSING LLC

Practice address

100 West St
Needham, MA 02494-1319

Phone

(781) 234-6300

NPI assigned

Jan 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brad Rolph

Title

Cfo

Phone

(781) 297-8626

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Avery Manor Doing business as

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144209289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KERRY PL",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624775",
            "telephone_number": "781-619-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941319",
            "telephone_number": "781-234-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEEDHAM NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLPH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "781-297-8626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0926272",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avery Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Needham, MA
• Providers in Needham, MA by specialty
• Skilled Nursing Facility in Massachusetts

• 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.