Individual provider Active NPI

Cory Michael Nohl, M.D.

  • Psychiatry Physician
  • Gardner, MA
National Provider Identifier
1184880569
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
274449 Issued in MA
Practice address
242 Green St
Gardner, MA 01440
Phone
(978) 632-3420
NPI assigned
Aug 5, 2008
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 274449 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440

Mailing address

242 Green St
Gardner, MA 01440-1373
Phone (978) 632-3420

Other practice location 1

446 E Ontario St Ste 6-300
Chicago, IL 60611-4418
Phone (312) 926-8200 ext. 42051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101005000037 VT Practitioner - Psychiatry 9638361082 Reassigns benefits to 1 organization
I20180606002269 MA Practitioner - Psychiatry 9638361082 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2018 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince May 11, 2024 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2018 Accepting new patients
Heywood Medical Group Inc. CurrentSince May 1, 2019 Accepting new patients
Brattleboro Retreat CurrentSince Jul 19, 2010 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1184880569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401373",
            "telephone_number": "978-632-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-632-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "446 E Ontario St Ste 6-300",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114418",
            "country_code": "US",
            "telephone_number": "312-926-8200 x42051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOHL",
        "first_name": "CORY",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "274449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.