Stephen J Poor III MDPC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

31356 Issued in MA

Legal business name

STEPHEN J POOR III MDPC

Practice address

17 Village SQ
Chelmsford, MA 01824-2712

Phone

(978) 250-8001

Fax

(978) 250-4142

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Stephen Joseph Poor III, M.D.NPI 1144209685

Title

President

Phone

(978) 250-8001

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Stephen Joseph Poor III, MD

  • Ophthalmology Physician
  • Chelmsford, MA
  • NPI 1144209685
  Authorized official Same address or phone

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457306540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDWARD ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212303",
            "telephone_number": "781-828-3533",
            "fax_number": "781-828-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 VILLAGE SQ",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242712",
            "telephone_number": "978-250-8001",
            "fax_number": "978-250-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN J POOR III MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POOR",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-250-8001",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "31356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9724583",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "M13035",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Chelmsford, MA
• Providers in Chelmsford, MA by specialty
• Ophthalmology Physician in Massachusetts

• 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.