NPIMap

Organization Active NPI

Henry Heywood Memorial Hospital

Doing business as Heywood Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
National Provider Identifier
1457685299
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
2036 Issued in MA
Legal business name
HENRY HEYWOOD MEMORIAL HOSPITAL
Doing business as
Heywood Hospital
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(978) 632-3420
Fax
(978) 630-6596
NPI assigned
Sep 28, 2009
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH CENTRAL HEALTHCARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Thomas J Sullivan
Title
Ceo
Phone
(978) 630-6157

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 2036 MA Primary
Geriatric Psychiatry Physician 2084P0805X 2036 MA

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

Other identifiers 2

IdentifierTypeStateIssuer
1000306MedicaidMA
1200739MedicaidMA

Other names 1

  • Heywood Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081201000105 MA Part A Provider - Hospital 1658262605 Practice locations: Gardner, MA
O20250820000982 CA Part B Supplier - Clinic/Group Practice 1658262605 Receives reassigned benefits from 2 practitioners
Practice locations: San Diego, CA; South Pasadena, CA; Vista, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457685299. Details of each certification follow.

Hospital certification: CCN 22S095

Legal name
HENRY HEYWOOD MEMORIAL HOSPITAL
Doing business as
HEYWOOD HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
May 14, 1907 in MA
Enrollment address
242 Green St
Gardner, MA 14401336
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Heywood Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

235 Green St
Gardner, MA 01440
Phone (978) 630-2770

250 Green St
Ste 107
Gardner, MA 01440
Phone (978) 630-5050

250 Green St
Ste 110
Gardner, MA 01440
Phone (978) 630-5030

250 Green St
Ste 205
Gardner, MA 01440
Phone (978) 632-0383

250 Green St
Ste 208
Gardner, MA 01440
Phone (978) 630-6130

69 Pearson Blvd
Gardner, MA 01440
Phone (978) 630-6900

211 N Main St
Petersham, MA 01366
Phone (978) 724-0010

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert L Crosby Individual Corporate Officer Mar 1, 2010
W-2 Managing Employee Mar 1, 2010
Craig S Twohey Individual Corporate Director Feb 1, 2015
Joanne a Parks Individual Corporate Director Oct 1, 2008
Debra L Vescovi Individual Corporate Director Jan 23, 2019
Thomas Sullivan Individual Corporate Officer Feb 5, 2024
Corporate Director Feb 5, 2024
W-2 Managing Employee Feb 5, 2024
Elizabeth M Nottleson Individual Corporate Director Dec 1, 2014
W-2 Managing Employee Sep 7, 2004
Albert S Rose Individual Corporate Director Jan 25, 2018
Kenneth J Pierce Individual Corporate Director Oct 1, 2008
John Bujak Individual Corporate Officer Apr 1, 2024
Corporate Director Apr 1, 2024
W-2 Managing Employee Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Roy V Lake Individual Corporate Director Dec 31, 2012
Heywood Healthcare Inc Organization, Gardner, MA Non-profit Operational/Managerial Control Dec 31, 2012
Tina M Sbrega Individual Corporate Director Oct 1, 2008
Cheney M Castine Individual Corporate Director Dec 31, 2012
Glenn a Hunt Individual Corporate Director Oct 1, 2008
James W Meehan Individual Corporate Director Dec 31, 2012
John M Skrzypczak Individual Corporate Director Oct 1, 2008
Robert F Chauvin Individual Corporate Director Dec 31, 2012
Michele C Parker Individual Corporate Director Dec 31, 2012
Joel R Shaughnessy Individual Corporate Director Dec 31, 2012
Joyce C Fletcher Individual Corporate Director Oct 1, 2008
Benjamin D Prentiss Individual Corporate Director Jan 1, 2017

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 371

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 371

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1457685299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420",
            "fax_number": "978-630-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420",
            "fax_number": "978-630-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY HEYWOOD MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH CENTRAL HEALTHCARE, INC",
        "enumeration_date": "2009-09-28",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-630-6157"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MA",
            "license": "2036",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MA",
            "license": "2036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000306",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200739",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heywood Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heywood Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.