NPIMap

Organization Active NPI

Edward M. Kennedy Community Health Center, Inc

  • Community/Retail Pharmacy
  • Framingham, MA
National Provider Identifier
1275200461
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC
Practice address
354 Waverley St FL 3
Framingham, MA 01702-7079
Phone
(800) 853-2288
NPI assigned
Aug 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
David Small
Title
Vice President, Human Resources
Phone
(508) 532-7315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

354 Waverley St FL 3
Framingham, MA 01702-7079

Mailing address

115 NE Cutoff Ste 200
Worcester, MA 01606-1224
Phone (508) 532-7315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260601000607 MA Part B Supplier - Pharmacy 3476512740 3 other NPIs on this enrollment
Practice locations: Worcester, MA; Milford, MA; Framingham, MA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Edward M Kennedy Community Health Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

354 Waverley St
Fl 3
Framingham, MA 01702
Phone (508) 215-0215

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1275200461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NE CUTOFF STE 200",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016061224",
            "telephone_number": "508-532-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 WAVERLEY ST FL 3",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017027079",
            "telephone_number": "800-853-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT, HUMAN RESOURCES",
        "authorized_official_telephone_number": "508-532-7315"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.