NPIMap

Organization Active NPI

North Shore Pet Imaging Center

  • Mobile Radiology Clinic/Center
  • Peabody, MA
National Provider Identifier
1407898760
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
4C5F Issued in MA
Legal business name
NORTH SHORE PET IMAGING CENTER
Practice address
68 Prospect St
Peabody, MA 01960-1605
Phone
(978) 532-8960
Fax
(978) 532-9163
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Eleanor None Richardson
Title
Executive Director
Phone
(978) 573-3116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 4C5F MA Primary

Addresses

Primary practice location

68 Prospect St
Peabody, MA 01960-1605

Mailing address

68 Prospect St
Peabody, MA 01960-1605
Phone (978) 532-8960

Other identifiers 5

IdentifierTypeStateIssuer
039669OtherMABC/BS OF MA
641402OtherMATUFTS HEALTH PLAN
0034316OtherMANEIGHBORHOOD HEALTH
3732728OtherMAAETNA
AA20785OtherMAHARVARD PILGRIM HEALTH

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407898760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PROSPECT ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601605",
            "telephone_number": "978-532-8960",
            "fax_number": "978-532-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 PROSPECT ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601605",
            "telephone_number": "978-532-8960",
            "fax_number": "978-532-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PET IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "NONE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-573-3116",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "MA",
            "license": "4C5F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA",
            "identifier": "039669",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "641402",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0034316",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3732728",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "AA20785",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.