NPIMap

Organization Active NPI

LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
National Provider Identifier
1417485541
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LGH PROFESSIONAL SERVICES LLC
Practice address
295 Varnum Ave
Lowell, MA 01854-2134
Phone
(978) 937-6000
NPI assigned
Jun 2, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CIRCLE HEALTH PHYSICIANS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. William F Wyman IV, MS, FACHE
Title
Vice President
Phone
(978) 937-6034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

295 Varnum Ave
Lowell, MA 01854-2134

Mailing address

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171103002152 MA Part B Supplier - Clinic/Group Practice 8921364159 Receives reassigned benefits from 10 practitioners
Practice locations: Lowell, MA; Tewksbury, MA; North Chelmsford, MA; North Billerica, MA; Chelmsford, MA

National Provider Directory

National Provider Directory
Part of
Circle Health Physicians Inc

Locations

254 Billerica Rd
Chelmsford, MA 01824
Phone (978) 256-0231

40 Parkhurst Rd
Chelmsford, MA 01824
Phone (978) 251-3151

1081 Varnum Ave
Lowell, MA 01854
Phone (978) 427-6810

500 Wentworth Ave
Lowell, MA 01852
Phone (978) 458-1271

80 Boston Rd
North Billerica, MA 01862
Phone (978) 667-2166

80 Boston Rd
#3A
North Billerica, MA 01862

10 Erlin Ter
Tewksbury, MA 01876
Phone (978) 851-3121

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 476

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.

View all 476

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417485541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134",
            "telephone_number": "978-937-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134",
            "telephone_number": "978-937-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LGH PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CIRCLE HEALTH PHYSICIANS, INC",
        "enumeration_date": "2017-06-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WYMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "978-937-6034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MS, FACHE"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.