Active NPI
Salaam Imani Hernandez, CERTIFICATION ECD
- Community Health Worker
- Dorchester, MA
National Provider Identifier
1578028908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 895 Blue Hill Ave
Dorchester, MA 02124 - Phone
- (857) 445-8419
- NPI assigned
- Feb 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
895 Blue Hill Ave
Dorchester, MA 02124
Mailing address
895 Blue Hill Ave
Boston, MA 02124-2902
Phone (857) 445-8419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000 | Other | NONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1578028908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 BLUE HILL AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021242902",
"telephone_number": "857-445-8419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 BLUE HILL AVE",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02124",
"telephone_number": "857-445-8419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "SALAAM",
"middle_name": "IMANI",
"credential": "CERTIFICATION ECD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "000000000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.