NPIMap

Organization Active NPI

Sudbury Pines Extended Care Facility

  • Inpatient Hospice
  • Sudbury, MA
National Provider Identifier
1265551733
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
License
7IQU Issued in MA
Legal business name
SUDBURY PINES EXTENDED CARE FACILITY
Doing business as
Sudbury Pines Hospice
Practice address
642 Boston Post Rd
Sudbury, MA 01776-3302
Phone
(978) 443-9000
Fax
(978) 443-9510
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Authorized official

Name
Ms. Roberta C Henderson
Title
President, Administrator
Phone
(978) 443-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X 7IQU MA Primary

Addresses

Primary practice location

642 Boston Post Rd
Sudbury, MA 01776-3302

Mailing address

642 Boston Post Rd
Sudbury, MA 01776-3302
Phone (978) 443-9000

Other identifiers 1

IdentifierTypeStateIssuer
0611000MedicaidMA

Other names 1

  • Sudbury Pines Hospice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sudbury Pines Extended Care Facility2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1265551733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 BOSTON POST RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017763302",
            "telephone_number": "978-443-9000",
            "fax_number": "978-443-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 BOSTON POST RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017763302",
            "telephone_number": "978-443-9000",
            "fax_number": "978-443-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDBURY PINES EXTENDED CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT, ADMINISTRATOR",
        "authorized_official_telephone_number": "978-443-9000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "MA",
            "license": "7IQU",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0611000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sudbury Pines Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sudbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.