Active NPI
Codman Square Health Center
- Optometrist
- Dorchester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2748
- Legal business name
- CODMAN SQUARE HEALTH CENTER
- Practice address
- 637 Washington Street
Dorchester, MA 02124 - Phone
- (617) 825-9660
- Fax
- (617) 288-7898
- NPI assigned
- Feb 22, 2008
- Last updated
- Feb 22, 2008
- Organization subpart
- Yes
- Parent organization
- CODMAN SQUARE HEALTH CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Philip Severin, MD
- Title
- Medical Director
- Phone
- (617) 825-9660
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2748 | MA | Primary |
Addresses
Primary practice location
637 Washington Street
Dorchester, MA 02124
Mailing address
637 Washington Street
Dorchester, MA 02124
Phone (617) 825-9660
National Provider Directory
National Provider Directory- Tax ID family
- Codman Square Health Ce
- Part of
- Codman Square Health Ce
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Health Clinic/Center
- Randolph, MA
- NPI 1003770736
-
- Clinical Social Worker
- Dorchester Center, MA
- NPI 1801099346
-
dba Codman Square Health Center Urgent Care
- Urgent Care Clinic/Center
- Dorchester, MA
- NPI 1922599117
Locations
637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Medicine Physician
- Dorchester Center, MA
- NPI 1689635534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203638400000",
"number": "1437328648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 WASHINGTON STREET",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02124",
"telephone_number": "617-825-9660",
"fax_number": "617-288-7898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "637 WASHINGTON STREET",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02124",
"telephone_number": "617-825-9660",
"fax_number": "617-288-7898"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CODMAN SQUARE HEALTH CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CODMAN SQUARE HEALTH CENTER",
"enumeration_date": "2008-02-22",
"last_updated": "2008-02-22",
"status": "A",
"authorized_official_last_name": "SEVERIN",
"authorized_official_first_name": "PHILIP",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "617-825-9660",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "MA",
"license": "2748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.