NPIMap

Organization Active NPI

Dimock Community Services Corp

  • Community/Behavioral Health Agency
  • Roxbury, MA
National Provider Identifier
1174677223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DIMOCK COMMUNITY SERVICES CORP
Practice address
1800 Columbus Ave
Roxbury, MA 02119-1042
Phone
(617) 442-8800
Fax
(617) 445-0091
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David Whitham
Title
Director It & Ar
Phone
(617) 442-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MA Primary

Addresses

Primary practice location

1800 Columbus Ave
Roxbury, MA 02119-1042

Mailing address

55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800

Other identifiers 1

IdentifierTypeStateIssuer
1887297MedicaidMA

Other names 1

  • Dimock Early Intervention Other name

National Provider Directory

National Provider Directory
Tax ID family
Dimock Community Health Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1800 Columbus Ave
Roxbury, MA 02119
Phone 6174428800 ext. 1144

Practitioners & affiliated clinicians

Practitioners 1

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174677223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800",
            "fax_number": "617-445-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COLUMBUS AVE",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191042",
            "telephone_number": "617-442-8800",
            "fax_number": "617-445-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMOCK COMMUNITY SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR IT & AR",
        "authorized_official_telephone_number": "617-442-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1887297",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dimock Early Intervention",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roxbury, MA

Sources for this page

  • 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.