NPIMap

Organization Active NPI

Town of Andover

  • State or Local Public Health Clinic/Center
  • Andover, MA
National Provider Identifier
1609913706
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
TOWN OF ANDOVER
Practice address
36 Bartlet St
Andover, MA 01810-3813
Phone
(978) 623-8640
Fax
(978) 623-8694
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Amy Ewing, RN
Title
Assistant Health Director
Phone
(978) 623-8640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

36 Bartlet St
Andover, MA 01810-3813

Mailing address

36 Bartlet St
Andover, MA 01810-3813
Phone (978) 623-8640

Other names 1

  • ANDOVER HEALTH DEPARTMENT Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130401000295 MA Part B Supplier - Mass Immunization (Roster Biller Only) 3072678747 Practice locations: Andover, MA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Andover Health Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

36 Bartlet St
Andover, MA 01810
Phone (978) 623-8640

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1609913706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 BARTLET ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103813",
            "telephone_number": "978-623-8640",
            "fax_number": "978-623-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 BARTLET ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103813",
            "telephone_number": "978-623-8640",
            "fax_number": "978-623-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF ANDOVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "EWING",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "ASSISTANT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "978-623-8640",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANDOVER HEALTH DEPARTMENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.