Active NPI
Town of Southborough
- Public Health or Welfare Agency
- Southborough, MA
National Provider Identifier
1376676130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- TOWN OF SOUTHBOROUGH
- Practice address
- 17 Common St
Southborough, MA 01772-1663 - Phone
- (508) 481-3013
- Fax
- (508) 480-0161
- NPI assigned
- Mar 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brian Paul Ballantine
- Title
- Finance Director
- Phone
- (508) 485-0710
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | MA | Primary |
Addresses
Primary practice location
17 Common St
Southborough, MA 01772-1663
Mailing address
17 Common St
Southborough, MA 01772-1663
Phone (508) 481-3013
Other names 1
- Southborough Board of Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091013000601 | MA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8729005541 | Practice locations: Southborough, MA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Southborough Board of Health
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Local Education Agency (LEA)
- Southborough, MA
- NPI 1285752394
-
- Ambulance
- Southborough, MA
- NPI 1326018201
Locations
9 Cordaville Rd
Southborough, MA 01772
Phone (505) 787-1048
17 Common St
Southborough, MA 01772
Phone (508) 481-3013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1376676130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 COMMON ST",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721663",
"telephone_number": "508-481-3013",
"fax_number": "508-480-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 COMMON ST",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721663",
"telephone_number": "508-481-3013",
"fax_number": "508-480-0161"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOWN OF SOUTHBOROUGH",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BALLANTINE",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "PAUL",
"authorized_official_title_or_position": "FINANCE DIRECTOR",
"authorized_official_telephone_number": "508-485-0710",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southborough Board of Health",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Southborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.