SRK MD, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

209939 Issued in MA

Legal business name

SRK MD, LLC

Practice address

210 Bear Hill Rd Ste 304
Waltham, MA 02451-1025

Phone

(781) 684-0600

Fax

(781) 684-0601

NPI assigned

Jun 25, 2017

Organization subpart

Yes

Parent organization

STEVEN R. KANNER, MD, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Steven R. Kanner, MDNPI 1740270289

Title

Owner

Phone

(781) 684-0600

Specialties & licenses 1

Addresses

Part of

Steven R Kanner MD LLC

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.

• Steven R. Kanner, MD, LLC

  • Internal Medicine Physician
  • Waltham, MA
  • NPI 1679603757
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven R Kanner, MD

  • Internal Medicine Physician
  • Waltham, MA
  • NPI 1740270289
  NPD Authorized official

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498348800000",
    "number": "1578083119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BYPASS RD",
            "city": "LINCOLN",
            "state": "MA",
            "postal_code": "017731202",
            "telephone_number": "781-259-0222",
            "fax_number": "781-259-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL RD STE 304",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511025",
            "telephone_number": "781-684-0600",
            "fax_number": "781-684-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRK MD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEVEN R. KANNER, MD, LLC",
        "enumeration_date": "2017-06-25",
        "last_updated": "2017-06-25",
        "status": "A",
        "authorized_official_last_name": "KANNER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-684-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "209939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brynn Speroni
• Timothy Spinale
• Brooke Spinnichia
• Debra Lynn Spitz, LICSW
• Nicole Spruce
• William Ssegujja
• Robert Ssekiranda
• Sarah Zawedde Ssentongo
• Christina St Simon
• St. Elizabeth Medical Center

• Internal Medicine Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2017; 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.