NPIMap

Organization Active NPI

Clipper Cardiovascular Associates, Inc

  • Cardiovascular Disease Physician
  • Newburyport, MA
National Provider Identifier
1174512727
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CLIPPER CARDIOVASCULAR ASSOCIATES, INC
Practice address
112A Parker St
Newburyport, MA 01950-4008
Phone
(978) 462-1110
Fax
(978) 462-3889
NPI assigned
Oct 17, 2005
Organization subpart
Yes
Parent organization
CLIPPER CARDIOVASCULAR ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Authorized official

Name
Mr. William T Johnson
Title
Vice President
Phone
(804) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

112A Parker St
Newburyport, MA 01950-4008

Mailing address

112A Parker St
Newburyport, MA 01950-4008
Phone (878) 462-1110

Other identifiers 4

IdentifierTypeStateIssuer
30214198MedicaidNH
9744011MedicaidMA
M18764OtherMABCBS OF MASS
9788506MedicaidNH

Other names 1

  • dba Clipper Cardiovascular Associates Doing business as

National Provider Directory

National Provider Directory
Part of
Wentworth Douglass Hospital

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

112A Parker St
Newburyport, MA 01950
Phone (978) 462-1110

55 High St
Ste 203
Hampton, NH 03842
Phone (603) 758-1155

Practitioners & affiliated clinicians

Practitioners 8

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": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335484800000",
    "number": "1174512727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112A PARKER ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019504008",
            "telephone_number": "878-462-1110",
            "fax_number": "978-462-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112A PARKER ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019504008",
            "telephone_number": "978-462-1110",
            "fax_number": "978-462-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIPPER CARDIOVASCULAR ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLIPPER CARDIOVASCULAR ASSOCIATES",
        "enumeration_date": "2005-10-17",
        "last_updated": "2012-04-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-237-7760",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30214198",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9744011",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASS",
            "identifier": "M18764",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9788506",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Clipper Cardiovascular Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.