NPIMap

Organization Active NPI

Internal Medicine and Endocrinology, Inc.

  • Primary Care Clinic/Center
  • Worcester, MA
National Provider Identifier
1376709683
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
35925 Issued in MA
Legal business name
INTERNAL MEDICINE AND ENDOCRINOLOGY, INC.
Practice address
255 Park Ave
Suite 210
Worcester, MA 01609-1953
Phone
(508) 754-8000
Fax
(508) 752-8286
NPI assigned
Aug 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Dr. John Paul Lock, M.D.
Title
Medical Director
Phone
(508) 754-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 35925 MA Primary

Addresses

Primary practice location

255 Park Ave
Suite 210
Worcester, MA 01609-1953

Mailing address

255 Park Ave
Suite 210
Worcester, MA 01609-1953
Phone (508) 754-8000

Other identifiers 1

IdentifierTypeStateIssuer
2055643MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1376709683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 210",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-754-8000",
            "fax_number": "508-752-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 210",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-754-8000",
            "fax_number": "508-752-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND ENDOCRINOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "508-754-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MA",
            "license": "35925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2055643",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.