NPIMap

Organization Active NPI

Northeast Hospital Corporation

  • Geriatric Medicine (Internal Medicine) Physician
  • Danvers, MA
National Provider Identifier
1164547063
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
NORTHEAST HOSPITAL CORPORATION
Practice address
480 Maple St
Center for Healthy Aging
Danvers, MA 01923-4065
Phone
(866) 479-3302
Fax
(978) 921-7048
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Mr. Denis S Conroy
Title
Ceo
Phone
(978) 922-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

480 Maple St
Center for Healthy Aging
Danvers, MA 01923-4065

Mailing address

85 Herrick Street
Medical Staff Office
Beverly, MA 01915
Phone (978) 816-2732

National Provider Directory

National Provider Directory
Tax ID family
Northeast Hospital Corp11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

85 Herrick St
Ofc
Beverly, MA 01915

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1164547063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK STREET",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-816-2732",
            "fax_number": "978-921-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAPLE ST",
            "address_2": "CENTER FOR HEALTHY AGING",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234065",
            "telephone_number": "866-479-3302",
            "fax_number": "978-921-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-922-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.