NPIMap

Organization Active NPI

Chair City Family Medicine, PC

  • Family Medicine Physician
  • Gardner, MA
National Provider Identifier
1366411316
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHAIR CITY FAMILY MEDICINE, PC
Practice address
250 Green St
Gardner, MA 01440-1396
Phone
(978) 630-4455
Fax
(978) 669-0046
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Thomas Bryan Miller III, MD
Title
President
Phone
(978) 630-4455

Specialties & licenses 1

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

Addresses

Primary practice location

250 Green St
Gardner, MA 01440-1396

Mailing address

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-4455

Other identifiers 1

IdentifierTypeStateIssuer
9716530MedicaidMA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/537/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1366411316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-630-4455",
            "fax_number": "978-669-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-630-4455",
            "fax_number": "978-669-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAIR CITY FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-630-4455",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9716530",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.