Radius Millbury Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0158 Issued in MA

Legal business name

RADIUS MILLBURY OPERATING LLC

Practice address

29 Main St
Millbury, MA 01527-2005

Phone

(508) 865-6106

Fax

(508) 865-7559

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Carey Lynne Andrus

Title

Ar Billing Manager

Phone

(508) 865-6106

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528055696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MAIN ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272005",
            "telephone_number": "508-865-6106",
            "fax_number": "508-865-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MAIN ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272005",
            "telephone_number": "508-865-6106",
            "fax_number": "508-865-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIUS MILLBURY OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "CAREY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "AR BILLING MANAGER",
        "authorized_official_telephone_number": "508-865-6106",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0926710",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.