Dodge Park at Home

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

8110 Issued in MA

Legal business name

DODGE PARK AT HOME

Practice address

101 Randolph Rd
Worcester, MA 01606-2463

Phone

(508) 853-8180

Fax

(508) 853-4545

NPI assigned

Feb 16, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Micha Shalev

Title

Manager/Member

Phone

(508) 853-8180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1487927778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RANDOLPH RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062463",
            "telephone_number": "508-853-8180",
            "fax_number": "508-853-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RANDOLPH RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062463",
            "telephone_number": "508-853-8180",
            "fax_number": "508-853-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE PARK AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "SHALEV",
        "authorized_official_first_name": "MICHA",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "508-853-8180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MA",
            "license": "8110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose M Doan
• Elizabeth Lea Dobell, MD
• Elizabeth Dobles, MD
• Michelina Libera Docimo, M.S.
• Dominique Matica Dockery, MD
• Dodge Park LLC
• Dodge Park Rest Home Inc.
• Linda L Dodge, N.P.
• Robyn Dodge
• Hannah Dodier

• All providers in Worcester, MA
• In Home Supportive Care Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.