Baystate Wing Hospital Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2181 Issued in MA

Legal business name

BAYSTATE WING HOSPITAL CORPORATION

Doing business as

Baystate Wing Hospital: Visiting Nurse Association & Hospice

Practice address

4 Springfield St., BLDG. 3, 4TH FL.
Three Rivers, MA 01080-1242

Phone

(413) 283-9715

Fax

(413) 283-8084

NPI assigned

Feb 12, 2007

Last updated

Oct 31, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

BAYSTATE WING HOSPITAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Keary T Allicon

Title

Treasurer & Cfo

Phone

(413) 284-5302

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Baystate Wing Hospital: Visiting Nurse Association & Hospice Doing business as

Part of

Winchester Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Baystate Wing Hospital Corporation

  dba Baystate Wing Hospital & Medical Centers

  • General Acute Care Hospital
  • Palmer, MA
  • NPI 1962410233

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1518009273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WRIGHT ST",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691138",
            "telephone_number": "413-283-9715",
            "fax_number": "413-283-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SPRINGFIELD ST., BLDG. 3, 4TH FL.",
            "city": "THREE RIVERS",
            "state": "MA",
            "postal_code": "010801242",
            "telephone_number": "413-283-9715",
            "fax_number": "413-283-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSTATE WING HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAYSTATE WING HOSPITAL CORPORATION",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "ALLICON",
        "authorized_official_first_name": "KEARY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "TREASURER & CFO",
        "authorized_official_telephone_number": "413-284-5302"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MA",
            "license": "2181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608149",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "120116",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "804738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "981443",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "18354",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HLTH CARE",
            "identifier": "702265",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baystate Wing Hospital: Visiting Nurse Association & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary-Alice R Austin, LICSW
• Gennie Bailey, LMHC
• Gina Marie Baldina, ARDMS
• Baystate Wing Hospital Corporation (Baystate Wing Hospital: Visiting Nurse Association & Hospice)
• Clinical and Support Options
• Louise Marie Davis
• Morria Heilman
• Stephen R Holuk, M.D.

• Home Health Agency in Three Rivers, MA
• Providers in Three Rivers, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.