South Shore Elder Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTH SHORE ELDER CARE

Practice address

1 Pearl St
Suite 2400
Brockton, MA 02301-2864

Phone

(508) 897-6130

Fax

(508) 897-6135

NPI assigned

Jun 27, 2007

Last updated

Aug 22, 2020By 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

Mrs. Linda Belanger

Title

Director

Phone

(508) 638-2510

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609072404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 575",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023790575",
            "telephone_number": "877-588-0821",
            "fax_number": "508-583-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 2400",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-897-6130",
            "fax_number": "508-897-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE ELDER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELANGER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "508-638-2510",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0402979",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9783946",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "BRV03880",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHPLAN",
            "identifier": "052504",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "66510",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Bay Mental Health Center, Inc.
• South Bay Mental Health Center, Inc.
• South Bay Mental Health Center, Inc. (South Bay Community Services)
• South Bay Mental Health Center, Inc.
• South Shore Adult Day Health Center LLC
• South Surburban Oncology
• Southbay Community Services
• Southeast Orthodontics, Inc.
• Southeastern Massachusetts Regional MRI, Limited Partnership (Brockton Regional MRI Center)
• Southeastern Oral & Maxillofacial Surgeons PC

• Internal Medicine Physician in Brockton, MA
• Providers in Brockton, 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 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.