NPIMap

Organization Active NPI

Cherry Street Physical Medicine PC

  • Physical Medicine & Rehabilitation Physician
  • Danvers, MA
National Provider Identifier
1659722924
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
248773 Issued in MA
Legal business name
CHERRY STREET PHYSICAL MEDICINE PC
Practice address
15 Cherry St
Danvers, MA 01923-2880
Phone
(978) 774-4468
NPI assigned
Jun 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Authorized official

Name
Dr. William NolanNPI 1316900426
Title
Chief Operating Officer
Phone
(978) 774-4468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 248773 MA Primary

Addresses

Primary practice location

15 Cherry St
Danvers, MA 01923-2880

Mailing address

15 Cherry St
Danvers, MA 01923-2880
Phone (978) 774-4468

National Provider Directory

National Provider Directory

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": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1659722924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHERRY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232880",
            "telephone_number": "978-774-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHERRY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232880",
            "telephone_number": "978-774-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY STREET PHYSICAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "978-774-4468",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "248773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.