Wingate at Wilbraham, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0885 Issued in MA

Legal business name

WINGATE AT WILBRAHAM, INC.

Doing business as

Wingate at Wilbraham Rehab. & Skilled Nsg. Residence

Practice address

9 Maple St
Wilbraham, MA 01095-1730

Phone

(413) 596-2411

Fax

(413) 599-1738

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Tamilyn M. Levin, ESQ.

Title

Cfo

Phone

(781) 707-9510

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wingate at Wilbraham Rehab. & Skilled Nsg. Residence Doing business as

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1184673097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942708",
            "telephone_number": "781-707-9085",
            "fax_number": "781-707-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MAPLE ST",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951730",
            "telephone_number": "413-596-2411",
            "fax_number": "413-599-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGATE AT WILBRAHAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "TAMILYN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "781-707-9510",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026240B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wingate at Wilbraham Rehab. & Skilled Nsg. Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Wilbraham, MA
• Providers in Wilbraham, 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 Oct 5, 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.