NPIMap

Organization Active NPI

Vineyard Healthcare Assoc.

  • Addiction Medicine (Family Medicine) Physician
  • Vineyard Haven, MA
National Provider Identifier
1194949073
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
VINEYARD HEALTHCARE ASSOC.
Practice address
455 State Rd Ste 13
Vineyard Haven, MA 02568-5621
Phone
(508) 693-3900
Fax
(508) 693-0444
NPI assigned
Apr 12, 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
Miss Cheryl A Church
Title
Office Manager
Phone
(617) 447-2146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

455 State Rd Ste 13
Vineyard Haven, MA 02568-5621

Mailing address

59 Temple PL Ste 662
Boston, MA 02111-1307
Phone (617) 447-2146

Other names 1

  • preventive medicine assoc. inc. Other name

National Provider Directory

National Provider Directory
Tax ID family
Springfield International Health Center29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

59 Temple Pl
Ste 662
Boston, MA 02111

455 State Rd
Ste 13
Vineyard Haven, MA 02568
Phone (508) 693-3900

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194949073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 TEMPLE PL STE 662",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111307",
            "telephone_number": "617-447-2146",
            "fax_number": "617-259-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 STATE RD STE 13",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025685621",
            "telephone_number": "508-693-3900",
            "fax_number": "508-693-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINEYARD HEALTHCARE ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "617-447-2146",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "preventive medicine assoc. inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vineyard Haven, 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.