NPIMap

Organization Active NPI

Brockton Neighborhood H. C.

  • Preferred Provider Organization
  • Brockton, MA
National Provider Identifier
1619066917
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
1210420 Issued in MA
Legal business name
BROCKTON NEIGHBORHOOD H. C.
Practice address
231 Main St
302
Brockton, MA 02301-4342
Phone
(508) 559-1567
Fax
(508) 559-5073
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julius N. Coles, MDS
Title
Dentisry
Phone
(508) 584-2708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 1210420 MA Primary

Addresses

Primary practice location

231 Main St
302
Brockton, MA 02301-4342

Mailing address

231 Main St
200
Brockton, MA 02301-4342
Phone (508) 584-2708

National Provider Directory

National Provider Directory
Tax ID family
Brockton Neighborhood Health Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

231 Main St
Ste 200
Brockton, MA 02301
Phone (508) 232-6290

231 Main St
Ste 302
Brockton, MA 02301
Phone (508) 559-1567

Practitioners & affiliated clinicians

Practitioners 1

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619066917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "address_2": "200",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "508-584-2708",
            "fax_number": "508-559-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "address_2": "302",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "508-559-1567",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON NEIGHBORHOOD H. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLES",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "DENTISRY",
        "authorized_official_telephone_number": "508-584-2708",
        "authorized_official_credential": "MDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MA",
            "license": "1210420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • 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.