NPIMap

Organization Active NPI

Gavin Foundation

  • Clinic/Center
  • South Boston, MA
National Provider Identifier
1396079414
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0853 Issued in MA
Legal business name
GAVIN FOUNDATION
Practice address
49 L St
South Boston, MA 02127-1511
Phone
(617) 268-5000
Fax
(617) 268-5008
NPI assigned
Sep 22, 2009
Last updated
Sep 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Authorized official

Name
Mr. John McGahan, LADC INPI 1225542582
Title
President/Ceo
Phone
(617) 268-5517

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0853 MA Primary

Addresses

Primary practice location

49 L St
South Boston, MA 02127-1511

Mailing address

675 E 4TH St
South Boston, MA 02127-3063
Phone (617) 268-5517

National Provider Directory

National Provider Directory

Locations

675 E 4th St
South Boston, MA 02127
Phone (617) 268-5000

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

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": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1396079414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 E 4TH ST",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021273063",
            "telephone_number": "617-268-5517",
            "fax_number": "617-269-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 L ST",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271511",
            "telephone_number": "617-268-5000",
            "fax_number": "617-268-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVIN FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "MCGAHAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "617-268-5517",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LADC I"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": "0853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; 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.