NPIMap

Organization Active NPI

Southcoast Pain and Rehabilitation Center

  • Chiropractor
  • New Bedford, MA
National Provider Identifier
1205142189
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOUTHCOAST PAIN AND REHABILITATION CENTER
Practice address
651 Orchard St
Suite 206
New Bedford, MA 02744-1008
Phone
(508) 991-8400
Fax
(508) 991-8788
NPI assigned
Aug 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Ms. Lisa F. Shestack
Title
Credentialing Manager
Phone
(508) 384-9424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

651 Orchard St
Suite 206
New Bedford, MA 02744-1008

Mailing address

651 Orchard St
Suite 206
New Bedford, MA 02744-1008
Phone (508) 991-8400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1205142189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ORCHARD ST",
            "address_2": "SUITE 206",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027441008",
            "telephone_number": "508-991-8400",
            "fax_number": "508-991-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 ORCHARD ST",
            "address_2": "SUITE 206",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027441008",
            "telephone_number": "508-991-8400",
            "fax_number": "508-991-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCOAST PAIN AND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "SHESTACK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "508-384-9424",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.