NPIMap

Organization Active NPI

Preventive Medicine Associates

Doing business as Wareham Wellness Center

  • Addiction Medicine (Family Medicine) Physician
  • Wareham, MA
National Provider Identifier
1447584800
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Doing business as
Wareham Wellness Center
Practice address
166 Main St
Wareham, MA 02571-4101
Phone
(508) 295-6700
Fax
(508) 295-2348
NPI assigned
Oct 1, 2009
Last updated
Oct 1, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
PREVENTIVE MEDICINE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Authorized official

Name
Ms. Mary J Delong, MM,RHIA
Title
Credentialing Manager
Phone
(413) 222-7711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

166 Main St
Wareham, MA 02571-4101

Mailing address

166 Main St
Wareham, MA 02571-4101
Phone (508) 295-6700

Other names 1

  • Wareham Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vineyard Healthcare Assoc29 organizations share this tax ID, including this one
Part of
Vineyard Healthcare Assoc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1447584800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025714101",
            "telephone_number": "508-295-6700",
            "fax_number": "508-295-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025714101",
            "telephone_number": "508-295-6700",
            "fax_number": "508-295-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "413-222-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MM,RHIA"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wareham Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.