Organization Active NPI

Wellcrest

  • Addiction Medicine (Family Medicine) Physician
  • Marblehead, MA
National Provider Identifier
1366787194
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
WELLCREST
Practice address
238 Washington St
Marblehead, MA 01945-3367
Phone
(781) 639-2260
Fax
(781) 348-6414
NPI assigned
Dec 5, 2012
Last updated
Dec 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Dr. Norma Iris Lopez, D.O.
Title
Family Physician
Phone
(781) 639-2260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X MA Primary

Addresses

Primary practice location

238 Washington St
Marblehead, MA 01945-3367

Mailing address

238 Washington St
Marblehead, MA 01945-3367
Phone (781) 639-2260

National Provider Directory

National Provider Directory

Locations

238 Washington St
Marblehead, MA 01945
Phone (781) 290-7870

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1366787194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 WASHINGTON ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453367",
            "telephone_number": "781-639-2260",
            "fax_number": "781-348-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 WASHINGTON ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453367",
            "telephone_number": "781-639-2260",
            "fax_number": "781-348-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "IRIS",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "781-639-2260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.