NPIMap

Organization Active NPI

Kennedy Donovan Center, Inc

  • Adult Care Home Facility
  • South Yarmouth, MA
National Provider Identifier
1376761734
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
KENNEDY DONOVAN CENTER, INC
Practice address
32 Commercial St
South Yarmouth, MA 02664-4441
Phone
(508) 385-6019
NPI assigned
Apr 23, 2007
Last updated
Mar 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Authorized official

Name
Mr. Kevin Rodman-Conare
Title
Ceo President
Phone
(508) 772-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X MA Primary

Addresses

Primary practice location

32 Commercial St
South Yarmouth, MA 02664-4441

Mailing address

1 Commercial St
Foxboro, MA 02035-2530
Phone (508) 543-2542

Other identifiers 1

IdentifierTypeStateIssuer
110026352HMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Residential Home10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Commercial St
Foxborough, MA 02035
Phone (508) 772-1200

32 Commercial St
South Yarmouth, MA 02664
Phone (508) 385-6019

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1376761734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COMMERCIAL ST",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352530",
            "telephone_number": "508-543-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COMMERCIAL ST",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026644441",
            "telephone_number": "508-385-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY DONOVAN CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "RODMAN-CONARE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "508-772-1210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026352H",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Yarmouth, MA

Sources for this page

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