NPIMap

Organization Active NPI

Coordinated Primary Care Dba Healthalliance Pulmonary

  • Pulmonary Disease Physician
  • Leominster, MA
National Provider Identifier
1518092485
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
COORDINATED PRIMARY CARE DBA HEALTHALLIANCE PULMONARY
Practice address
50 Memorial Drive
Suite 113
Leominster, MA 01453
Phone
(978) 466-2692
Fax
(978) 466-4754
NPI assigned
Feb 22, 2007
Organization subpart
Yes
Parent organization
COORDINATED PRIMARY CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Authorized official

Name
Phyllis Fabello
Title
Executive Director
Phone
(978) 466-4268

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Allergy & Immunology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0201X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 216511 MA
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

50 Memorial Drive
Suite 113
Leominster, MA 01453

Mailing address

50 Memorial Drive
Suite 113
Leominster, MA 01453
Phone (978) 466-2692

Other identifiers 1

IdentifierTypeStateIssuer
9771476MedicaidMA

Other names 1

  • HEALTHALLIANCE PULMONARY Doing business as

National Provider Directory

National Provider Directory
Part of
Coordinated Primary Care Inc

Locations

50 Memorial Dr
Ste 113
Leominster, MA 01453
Phone (978) 466-2692

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1518092485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 113",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2692",
            "fax_number": "978-466-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 113",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2692",
            "fax_number": "978-466-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED PRIMARY CARE DBA HEALTHALLIANCE PULMONARY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COORDINATED PRIMARY CARE",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "FABELLO",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-466-4268"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "216511",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9771476",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHALLIANCE PULMONARY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.