Organization Active NPI

Town of Marblehead

  • Public Health or Welfare Agency
  • Marblehead, MA
National Provider Identifier
1508982422
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
TOWN OF MARBLEHEAD
Practice address
7 Widger Rd
Mary Alley Municipal Building
Marblehead, MA 01945-2197
Phone
(781) 631-0212
Fax
(781) 639-3064
NPI assigned
Mar 22, 2007
Last updated
Jul 29, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
TOWN OF MARBLEHEADAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Mr. Wayne D Attridge
Title
Director of Public Health
Phone
(781) 631-0212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary
Public Health & General Preventive Medicine Physician 2083P0901X NU

Addresses

Primary practice location

7 Widger Rd
Mary Alley Municipal Building
Marblehead, MA 01945-2197

Mailing address

7 Widger Rd
Mary Alley Municipal Building
Marblehead, MA 01945-2197
Phone (781) 631-0212

Other identifiers 1

IdentifierTypeStateIssuer
2739OtherMAMEDICARE EDI SUBMITTER ID

Other names 1

  • Board of Health Health Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101124000241 MA Part B Supplier - Mass Immunization (Roster Biller Only) 2264442540 Practice locations: Marblehead, MA

National Provider Directory

National Provider Directory
Tax ID family
Marblehead Ambulance2 organizations share this tax ID, including this one
Part of
Marblehead Ambulance

Other organizations with this tax ID 1

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

Locations

10 Humphrey St
Marblehead, MA 01945
Phone (781) 631-6225

7 Widger Rd
Marblehead, MA 01945
Phone (781) 631-0212

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1508982422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WIDGER RD",
            "address_2": "MARY ALLEY MUNICIPAL BUILDING",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452197",
            "telephone_number": "781-631-0212",
            "fax_number": "781-639-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WIDGER RD",
            "address_2": "MARY ALLEY MUNICIPAL BUILDING",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452197",
            "telephone_number": "781-631-0212",
            "fax_number": "781-639-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF MARBLEHEAD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOWN OF MARBLEHEAD",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "ATTRIDGE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF PUBLIC HEALTH",
        "authorized_official_telephone_number": "781-631-0212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE EDI SUBMITTER ID",
            "identifier": "2739",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Board of Health Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.