Emg Laboratory, LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

79586 Issued in MA

Legal business name

EMG LABORATORY, LLC

Practice address

51 Main St Ste 6
Hyannis, MA 02601

Phone

(508) 775-2600

Fax

(508) 775-1437

NPI assigned

Aug 22, 2017

Last updated

Jul 21, 2022By 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

Drasko Simovic, MDNPI 1306844220

Title

President

Phone

(508) 775-2600

Specialties & licenses 2

Addresses

Locations

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.

• Drasko Simovic, MD

  • Clinical Neurophysiology Physician
  • Lawrence, MA
  • NPI 1306844220

  Neurology

  NPD (past) Authorized official

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487170312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MAIN ST STE 6",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013109",
            "telephone_number": "508-775-2600",
            "fax_number": "508-775-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MAIN ST STE 6",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-775-2600",
            "fax_number": "508-775-1437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Main St",
            "address_purpose": "LOCATION",
            "city": "Hyannis",
            "state": "MA",
            "postal_code": "026013112",
            "country_code": "US",
            "telephone_number": "508-775-2600",
            "fax_number": "508-775-1437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMG LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SIMOVIC",
        "authorized_official_first_name": "DRASKO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-775-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "79586",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MA",
            "license": "79586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Christian Ellison, PHARM.D.
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• Ryann Emin, RN
• Lynne Irene Emmons-Boyd
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• Junean Engelsen, PA-C

• Clinical Neurophysiology Physician in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Clinical Neurophysiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.