Fairmount Rest Home, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

1387 Issued in MA

Legal business name

FAIRMOUNT REST HOME, INC.

Practice address

172 Fairmount Ave
172 Fairmount Ave
Hyde Park, MA 02136-3506

Phone

(617) 361-5150

Fax

(617) 361-7951

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Marden

Title

Owner

Phone

(617) 361-5150

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306971254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 FAIRMOUNT AVE",
            "address_2": "172 FAIRMOUNT AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363506",
            "telephone_number": "617-361-5150",
            "fax_number": "617-361-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 FAIRMOUNT AVE",
            "address_2": "172 FAIRMOUNT AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363506",
            "telephone_number": "617-361-5150",
            "fax_number": "617-361-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT REST HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARDEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-361-5150",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MA",
            "license": "1387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5505739",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility/Intermediate Care Facility in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Nursing Facility/Intermediate Care Facility 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.