Active NPI
Coordinated Primary Care Dba Healthalliance Urology
- Urology Physician
- Leominster, MA
National Provider Identifier
1578714390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- COORDINATED PRIMARY CARE DBA HEALTHALLIANCE UROLOGY
- Practice address
- 50 Memorial Dr
Suite 207
Leominster, MA 01453-2238 - Phone
- (978) 466-2121
- NPI assigned
- Oct 10, 2008
- Organization subpart
- Yes
- Parent organization
- COORDINATED PRIMARY CARE
NPPES NPI Registry
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) 466-4243
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MA | Primary |
Addresses
Primary practice location
50 Memorial Dr
Suite 207
Leominster, MA 01453-2238
Mailing address
50 Memorial Dr
Suite 207
Leominster, MA 01453-2238
Phone (978) 466-2121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M20928 | Other | MA | MEDICARE GROUP NUMBER |
| 9771476 | Medicaid | MA |
National Provider Directory
National Provider Directory- Part of
- Coordinated Primary Care Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1223596800000",
"number": "1578714390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 MEMORIAL DR",
"address_2": "SUITE 207",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532238",
"telephone_number": "978-466-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 MEMORIAL DR",
"address_2": "SUITE 207",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532238",
"telephone_number": "978-466-2121"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COORDINATED PRIMARY CARE DBA HEALTHALLIANCE UROLOGY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COORDINATED PRIMARY CARE",
"enumeration_date": "2008-10-10",
"last_updated": "2008-10-10",
"status": "A",
"authorized_official_last_name": "FABELLO",
"authorized_official_first_name": "PHYLLIS",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "978-466-4243"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "M20928",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9771476",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.