NPIMap

Organization Active NPI

Medical Group Inc

  • Clinical Medical Laboratory
  • Beverly, MA
National Provider Identifier
1467568899
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
2474 Issued in MA
Legal business name
MEDICAL GROUP INC
Practice address
77 Herrick St
Suite 101
Beverly, MA 01915-3012
Phone
(978) 927-4110
Fax
(978) 232-7057
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Authorized official

Name
Harriet A Bering, MDNPI 1063437788
Title
President
Phone
(978) 927-4110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 2474 MA Primary

Addresses

Primary practice location

77 Herrick St
Suite 101
Beverly, MA 01915-3012

Mailing address

77 Herrick St
Stite 101
Beverly, MA 01915-3012
Phone (978) 927-4110

Other identifiers 2

IdentifierTypeStateIssuer
0804436MedicaidMA
M16434OtherBLUE SHIELD

Other names 1

  • Cardiopulmonary Lab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cardiopulmonary Lab3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1467568899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "STITE 101",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153012",
            "telephone_number": "978-927-4110",
            "fax_number": "978-232-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "SUITE 101",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153012",
            "telephone_number": "978-927-4110",
            "fax_number": "978-232-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "BERING",
        "authorized_official_first_name": "HARRIET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-927-4110",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0804436",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "M16434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiopulmonary Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.