NPIMap

Organization Active NPI

Wachusett Medical Associates

Doing business as Kimberly W Ebb

  • Internal Medicine Physician
  • Leominster, MA
National Provider Identifier
1255470571
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151001 Issued in MA
Legal business name
WACHUSETT MEDICAL ASSOCIATES
Doing business as
Kimberly W Ebb
Practice address
50 Memorial Drive
Suite 108
Leominster, MA 01453
Phone
(978) 466-2277
Fax
(978) 466-2282
NPI assigned
Feb 5, 2007
Last updated
Sep 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Authorized official

Name
Kimberly Ebb, MDNPI 1790777589
Title
Owner Physician
Phone
(978) 466-2277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151001 MA Primary

Addresses

Primary practice location

50 Memorial Drive
Suite 108
Leominster, MA 01453

Mailing address

50 Memorial Drive
Suite 108
Leominster, MA 01453
Phone (978) 466-2277

Other identifiers 1

IdentifierTypeStateIssuer
3174671MedicaidMA

Other names 1

  • Kimberly W Ebb Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1255470571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 108",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2277",
            "fax_number": "978-466-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 108",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2277",
            "fax_number": "978-466-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACHUSETT MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "EBB",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "978-466-2277",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3174671",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimberly W Ebb",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.