Willow Street Family Practice Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

70411 Issued in MA

Legal business name

WILLOW STREET FAMILY PRACTICE INC

Doing business as

Patton Park Medical Center

Practice address

42 Asbury St
South Hamilton, MA 01982-1808

Phone

(978) 468-4101

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Bruce W Smith, M.D.NPI 1124065826

Title

Owner

Phone

(978) 468-4101

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Patton Park Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 2

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

• Bruce W Smith, M.D.

  • Family Medicine Physician
  • S Hamilton, MA
  • NPI 1124065826
  Medicare reassignment NPD Authorized official
• Michael A Edwards, MD

  • Family Medicine Physician
  • South Hamilton, MA
  • NPI 1386651073
  NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1619034410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 ASBURY ST",
            "city": "SOUTH HAMILTON",
            "state": "MA",
            "postal_code": "019821808",
            "telephone_number": "978-468-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 ASBURY ST",
            "city": "SOUTH HAMILTON",
            "state": "MA",
            "postal_code": "019821808",
            "telephone_number": "978-468-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW STREET FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-468-4101",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "70411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER NUMBE",
            "identifier": "M18879",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9738240",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patton Park Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alison Elizabeth Trimby, LICSW
• Emily Beth Trudeau
• Charles Vorrias, D.M.D
• Laura Anne Vorrias, DMD
• Jessica Hammon Webb, LICSW
• David Yarnell, MD
• Lirong Zhu

• Family Medicine Physician in South Hamilton, MA
• Providers in South Hamilton, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.