SRC Chestnut Hill SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SRC CHESTNUT HILL SNF, LLC

Practice address

615 Heath St
Chestnut Hill, MA 02467-2160

Phone

(617) 243-9990

NPI assigned

Nov 19, 2015

Last updated

Nov 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamilyn Levin

Title

Chief Financial Officer

Phone

(781) 707-9510

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1437523057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HEATH ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672160",
            "telephone_number": "617-243-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC CHESTNUT HILL SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "TAMILYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "781-707-9510"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelos Sourpis, M.D.
• Elizabeth Elaine Sparks, PH.D.
• Onir Leshem Spiegel, DDS
• Spine and Ortho of Ma
• SRC Chestnut Hill Alf, LLC
• Kelly Stamp, PHD, ANP
• Elizabeth Mary Stankiewicz, N.P.
• Star Optometry Ma PLLC (InFocus Eyecare)
• Lawrence A Starr, M.D.
• Meredith Beaton Starr, M.S.

• Skilled Nursing Facility in Chestnut Hill, MA
• Providers in Chestnut Hill, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.