NPIMap

Organization Active NPI

Erickson Health Medical Group of Massachusetts, P.C .

  • Skilled Nursing Facility
  • Peabody, MA
National Provider Identifier
1639447006
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2263574 Issued in MA
Legal business name
ERICKSON HEALTH MEDICAL GROUP OF MASSACHUSETTS, P.C .
Practice address
100 Brooksby Village Dr
Peabody, MA 01960-1438
Phone
(800) 523-9704
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
Dr. Matthew Narrett, M.D.
Title
Chief Medical Officer
Phone
(800) 523-9704

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2263574 MA
Skilled Nursing Facility 314000000X 2263574 MA Primary

Addresses

Primary practice location

100 Brooksby Village Dr
Peabody, MA 01960-1438

Mailing address

100 Brooksby Village Dr
Peabody, MA 01960-1438

National Provider Directory

National Provider Directory
Tax ID family
Erickson Health Medical Group of Massachusetts PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1639447006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BROOKSBY VILLAGE DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROOKSBY VILLAGE DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601438",
            "telephone_number": "800-523-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON HEALTH MEDICAL GROUP OF MASSACHUSETTS, P.C .",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "NARRETT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "800-523-9704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MA",
            "license": "2263574",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "2263574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.