Craig J Ungerman

Key facts

NPI

1144909284

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

Practice address

5 Optical Dr
Southbridge, MA 01550-2559

Phone

(508) 519-3590

Fax

(508) 849-3882

NPI assigned

Jul 17, 2023

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 17, 2023.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1144909284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 LETTERS ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062602016",
            "telephone_number": "860-942-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 OPTICAL DR",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502559",
            "telephone_number": "508-519-3590",
            "fax_number": "508-849-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGERMAN",
        "first_name": "CRAIG",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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