Agespan, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

AGESPAN, INC.

Practice address

280 Merrimack St
Suite 400
Lawrence, MA 01843

Phone

(978) 683-7747

Fax

(978) 687-1067

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Joan Hatem-Roy, LICSW

Title

Executive Director

Phone

(978) 683-7747

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1619007630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MERRIMACK ST",
            "address_2": "SUITE 400",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431779",
            "telephone_number": "978-683-7747",
            "fax_number": "978-687-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MERRIMACK ST",
            "address_2": "SUITE 400",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01843",
            "telephone_number": "978-683-7747",
            "fax_number": "978-687-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGESPAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "HATEM-ROY",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-683-7747",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAIVER",
            "identifier": "0603864",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lawrence, MA
• Case Management Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.