Southbridge OB GYN Assoc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

SOUTHBRIDGE OB GYN ASSOC

Practice address

100 South St
Ste G05
Southbridge, MA 01550

Phone

(508) 765-5981

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Melissa Ann Johnson, MD

Title

Physician

Phone

(508) 765-5981

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245393305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH ST",
            "address_2": "STE G05",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH ST",
            "address_2": "STE G05",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBRIDGE OB GYN ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "508-765-5981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9763236",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Southbridge, MA
• Providers in Southbridge, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• 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.