NPIMap

Organization Active NPI

Southcoast Physicians Group, Inc.

  • Emergency Medicine Physician
  • Fall River, MA
National Provider Identifier
1235646332
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTHCOAST PHYSICIANS GROUP, INC.
Practice address
374 William S Canning Blvd
Fall River, MA 02721-2352
Phone
(508) 973-2432
NPI assigned
Jan 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Kimberley Coon
Title
Director, Medical Staff SVCS
Phone
(508) 973-2432

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MA
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X MA

Addresses

Primary practice location

374 William S Canning Blvd
Fall River, MA 02721-2352

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other identifiers 5

IdentifierTypeStateIssuer
709004034OtherRIMEDICARE
M20518OtherMAMEDICARE
110072422AMedicaidMA
BM20689OtherRIMEDICAID
CD2506OtherMARAILROAD MEDICARE

Other names 1

  • Southcoast Urgent Care - Fall River Other name

National Provider Directory

National Provider Directory
Tax ID family
Jennifer S Levy D13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1235646332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 WILLIAM S CANNING BLVD",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027212352",
            "telephone_number": "508-973-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCOAST PHYSICIANS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "COON",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "DIRECTOR, MEDICAL STAFF SVCS",
        "authorized_official_telephone_number": "508-973-2432"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "709004034",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M20518",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072422A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "BM20689",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD2506",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southcoast Urgent Care - Fall River",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.