NPIMap

Organization Active NPI

Dr. Millard T. Hennessee, P.C.

  • Durable Medical Equipment & Medical Supplies
  • South Boston, MA
National Provider Identifier
1366601106
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1614 Issued in MA
Legal business name
DR. MILLARD T. HENNESSEE, P.C.
Practice address
654 E Broadway
South Boston, MA 02127-1502
Phone
(617) 268-1745
Fax
(617) 268-1748
NPI assigned
Jun 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Dr. Millard T. Hennessee
Title
President
Phone
(617) 268-1745

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 001614 MA
Durable Medical Equipment & Medical Supplies 332B00000X 1614 MA Primary

Addresses

Primary practice location

654 E Broadway
South Boston, MA 02127-1502

Mailing address

654 E Broadway
South Boston, MA 02127-1502
Phone (617) 268-1745

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1366601106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271502",
            "telephone_number": "617-268-1745",
            "fax_number": "617-268-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271502",
            "telephone_number": "617-268-1745",
            "fax_number": "617-268-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MILLARD T. HENNESSEE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "HENNESSEE",
        "authorized_official_first_name": "MILLARD",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-268-1745",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MA",
            "license": "001614",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "1614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.