VK Newburyport, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

VK NEWBURYPORT, LLC

Practice address

180 Low St
Newburyport, MA 01950-3519

Phone

(978) 465-5361

NPI assigned

Feb 20, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Barry Bokow

Title

Vice President

Phone

(516) 705-4802

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1245570779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 STAUDERMAN AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 LOW ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503519",
            "telephone_number": "978-465-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VK NEWBURYPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "BOKOW",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "516-705-4802",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110095728A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Newburyport, MA
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• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.