Active NPI
Wakefield Healthcare, LLC
Doing business as Wakefield Care and Rehabilitation Center
- Skilled Nursing Facility
- Wakefield, MA
National Provider Identifier
1316957681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0315
- Legal business name
- WAKEFIELD HEALTHCARE, LLC
- Doing business as
- Wakefield Care and Rehabilitation Center
- Practice address
- 1 Bathol St
Wakefield, MA 01880-3655 - Phone
- (781) 245-7600
- Fax
- (781) 245-2238
- NPI assigned
- Aug 9, 2006
- Organization subpart
- Yes
- Parent organization
- SUNBRIDGE HEALTHCARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael T Berg
- Title
- Officer
- Phone
- (505) 468-4742
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0315 | MA | Primary |
Addresses
Primary practice location
1 Bathol St
Wakefield, MA 01880-3655
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0940101 | Medicaid | MA |
Other names 1
- Wakefield Care and Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Terrace Hghts Nursing H
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Cottage of the Shoals
- Skilled Nursing Facility
- Tuscumbia, AL
- NPI 1285685362
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693267200000",
"number": "1316957681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-5604",
"fax_number": "505-468-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BATHOL ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803655",
"telephone_number": "781-245-7600",
"fax_number": "781-245-2238"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAKEFIELD HEALTHCARE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
"enumeration_date": "2006-08-09",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "505-468-4742"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "0315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0940101",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Wakefield Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Wakefield Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.