NPIMap

Organization Active NPI

American Diagnostic Lab., Inc.

  • Rehabilitation Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1316094584
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
34550 Issued in MA
Legal business name
AMERICAN DIAGNOSTIC LAB., INC.
Practice address
12 Hyde Park Ave
Jamaica Plain, MA 02130-4103
Phone
(508) 984-5200
Fax
(508) 996-8614
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mrs. Elizabeth C Medeiros
Title
Manager
Phone
(508) 984-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X 34550 MA Primary

Addresses

Primary practice location

12 Hyde Park Ave
Jamaica Plain, MA 02130-4103

Mailing address

12 Hyde Park Ave
Jamaica Plain, MA 02130-4103
Phone (508) 984-5200

Other identifiers 2

IdentifierTypeStateIssuer
AA61439OtherMAHARVARD PILGRIM
34994OtherMANEIGHBORHOOD HEALTH

Other names 1

  • Feel Well Rehab Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
American Diagnostic Lab Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1316094584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HYDE PARK AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304103",
            "telephone_number": "508-984-5200",
            "fax_number": "508-996-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HYDE PARK AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304103",
            "telephone_number": "508-984-5200",
            "fax_number": "508-996-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DIAGNOSTIC LAB., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MEDEIROS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "508-984-5200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "MA",
            "license": "34550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA61439",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "34994",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Feel Well Rehab Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.