455 Brayton Avenue Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0FBV Issued in MA

Legal business name

455 BRAYTON AVENUE OPERATIONS LLC

Doing business as

Somerset Ridge Center

Practice address

455 Brayton Ave
Somerset, MA 02726-2642

Phone

(508) 675-1001

Fax

(508) 675-1088

NPI assigned

Dec 4, 2007

Last updated

Oct 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael T Berg

Title

Secretary

Phone

(610) 444-6350

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Somerset Ridge Center Doing business as

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1578745394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 BRAYTON AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027262642",
            "telephone_number": "508-675-1001",
            "fax_number": "508-675-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "455 BRAYTON AVENUE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0FBV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110088688A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerset Ridge Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kareem M Abdalla, PHARMD
• Kent Farnham Ackley
• Jessica L Adams, PT
• Advantage Physical Therapy & Sports Rehabilitation, PC
• Amy Kathleen Andrade, OTR/L

• Skilled Nursing Facility in Somerset, MA
• Providers in Somerset, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.