Roscommon Healthcare Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ROSCOMMON HEALTHCARE INC.

Doing business as

Roscommon Extended Care Center

Practice address

405 River St
Mattapan, MA 02126-2210

Phone

(617) 296-5585

Fax

(617) 296-4907

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John P Burke, CPA

Title

Cfo

Phone

(617) 325-1688

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Roscommon Extended Care Center Doing business as

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1245316777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262210",
            "telephone_number": "617-296-5585",
            "fax_number": "617-296-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262210",
            "telephone_number": "617-296-5585",
            "fax_number": "617-296-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSCOMMON HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-325-1688",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0927104",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roscommon Extended Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Mattapan, MA
• Providers in Mattapan, 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 14, 2011; 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.