NPIMap

Organization Active NPI

South Boston Community Health Center

  • Clinic/Center
  • South Boston, MA
National Provider Identifier
1366626624
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SOUTH BOSTON COMMUNITY HEALTH CENTER
Practice address
409 W Broadway
South Boston, MA 02127-2245
Phone
(617) 269-7500
Fax
(617) 464-7581
NPI assigned
Dec 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Akinola Ogungbadero
Title
Cfo
Phone
(617) 269-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MA Primary

Addresses

Primary practice location

409 W Broadway
South Boston, MA 02127-2245

Mailing address

409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500

Other identifiers 1

IdentifierTypeStateIssuer
X10787OtherMABLUE CROSS DENTAL

National Provider Directory

National Provider Directory
Tax ID family
South Boston Community Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1366626624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500",
            "fax_number": "617-464-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500",
            "fax_number": "617-464-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BOSTON COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "OGUNGBADERO",
        "authorized_official_first_name": "AKINOLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-269-7500"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "X10787",
            "state": "MA"
        }
    ],
    "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 Dec 21, 2007; 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.