NPIMap

Organization Active NPI

Northern Berkshire Family Practice

  • Family Medicine Physician
  • North Adams, MA
National Provider Identifier
1306971635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHERN BERKSHIRE FAMILY PRACTICE
Practice address
820 State Rd
North Adams, MA 01247-3027
Phone
(413) 664-4088
Fax
(413) 663-6405
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Beth C Mantello
Title
Office Manager
Phone
(413) 664-4088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

820 State Rd
North Adams, MA 01247-3027

Mailing address

820 State Rd
PO Box 1067
North Adams, MA 01247-3027
Phone (413) 664-4088

Other identifiers 1

IdentifierTypeStateIssuer
9784535MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306971635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 STATE RD",
            "address_2": "PO BOX 1067",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012473027",
            "telephone_number": "413-664-4088",
            "fax_number": "413-663-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 STATE RD",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012473027",
            "telephone_number": "413-664-4088",
            "fax_number": "413-663-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN BERKSHIRE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANTELLO",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "413-664-4088"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9784535",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Adams, MA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.