Active NPI
Cornerstone Family Medicine, Inc.
- Family Medicine Physician
- Gardner, MA
National Provider Identifier
1619966421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CORNERSTONE FAMILY MEDICINE, INC.
- Practice address
- 250 Green St
Gardner, MA 01440-1396 - Phone
- (978) 669-0199
- Fax
- (978) 669-0054
- NPI assigned
- Oct 14, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michele Parker, M.D.
- Title
- President
- Phone
- (978) 669-0199
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
250 Green St
Gardner, MA 01440-1396
Mailing address
250 Green St
Gardner, MA 01440-1396
Phone (978) 669-0199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9717161 | Medicaid | MA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1449619200000",
"number": "1619966421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401396",
"telephone_number": "978-669-0199",
"fax_number": "978-669-0054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401396",
"telephone_number": "978-669-0199",
"fax_number": "978-669-0054"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORNERSTONE FAMILY MEDICINE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-14",
"last_updated": "2015-12-09",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "MICHELE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "978-669-0199",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9717161",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.