Active NPI
The Commonwealth of Massachusetts
- Long Term Care Hospital
- Jamaica Plain, MA
National Provider Identifier
1609946680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Hospital
- Legal business name
- THE COMMONWEALTH OF MASSACHUSETTS
- Practice address
- 170 Morton Street
Jamaica Plain, MA 02130-3735 - Phone
- (617) 522-8110
- Fax
- (617) 971-3850
- NPI assigned
- Nov 8, 2006
- Organization subpart
- Yes
- Parent organization
- THE COMMONWEALTH OF MASSACHUSETTS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Valenda Liptak
- Title
- Bureau Director, Public Health Hosp
- Phone
- (413) 784-9186
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chronic Disease Hospital | 281P00000X | |||
| Long Term Care Hospital | 282E00000X | Primary |
Addresses
Primary practice location
170 Morton Street
Jamaica Plain, MA 02130-3735
Mailing address
170 Morton Street
Jamaica Plain, MA 02130-3735
Phone (617) 522-8110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110078189A | Medicaid | MA |
Other names 1
- Lemuel Shattuck Hospital
National Provider Directory
National Provider Directory- Part of
- C Stanley Raymond
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648512000000",
"number": "1609946680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 MORTON STREET",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303735",
"telephone_number": "617-522-8110",
"fax_number": "617-971-3850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 MORTON STREET",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303735",
"telephone_number": "617-522-8110",
"fax_number": "617-971-3850"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE COMMONWEALTH OF MASSACHUSETTS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE COMMONWEALTH OF MASSACHUSETTS",
"enumeration_date": "2006-11-08",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A",
"authorized_official_last_name": "LIPTAK",
"authorized_official_first_name": "VALENDA",
"authorized_official_title_or_position": "BUREAU DIRECTOR, PUBLIC HEALTH HOSP",
"authorized_official_telephone_number": "413-784-9186"
},
"taxonomies": [
{
"code": "281P00000X",
"taxonomy_group": "",
"desc": "Chronic Disease Hospital",
"state": null,
"license": null,
"primary": false
},
{
"code": "282E00000X",
"taxonomy_group": "",
"desc": "Long Term Care Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110078189A",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lemuel Shattuck Hospital",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Lemuel Shattuck Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.