Bostonva Health Care System

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

143788 Issued in MA

Legal business name

BOSTONVA HEALTH CARE SYSTEM

Practice address

940 Belmont St
11PC
Brockton, MA 02301-5596

Phone

(508) 583-4500

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Marcia Ellen Graber, RNP

Title

Nurse Practitioner

Phone

(508) 583-4500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rosemary Mehl

  • Internal Medicine Physician
  • West Roxbury, MA
  • NPI 1609825587
  NPD (past)
• Eric Pruyne, LICSW

  • Clinical Social Worker
  • Brockton, MA
  • NPI 1336225580
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1386740538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "address_2": "11PC",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "address_2": "11PC",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "508-583-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTONVA HEALTH CARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "GRABER",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "508-583-4500",
        "authorized_official_credential": "RNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MA",
            "license": "143788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boston Medical Center Corporation
• Boston VA Healthcare System
• Boston VA Hospital
• Boston Vamc
• Boston Vamc
• Jacki M Boswell, LMHC
• Casey L Botelho, OTR/L
• Abigail Bouchard
• Jordan Lynn Boucher, RD
• Patricia Boucher, N.P.

• Primary Care Clinic/Center in Brockton, MA
• Providers in Brockton, MA by specialty
• Primary Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.