NPIMap

Organization Active NPI

Preventive Medicine Associates

  • Addiction Medicine (Family Medicine) Physician
  • Weymouth, MA
National Provider Identifier
1669696530
Registry record updated Mar 17, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Doing business as
Weymouth Medical Practice
Practice address
884 Washington St
2ND Floor
Weymouth, MA 02189-1530
Phone
(617) 447-2146
Fax
(617) 259-1627
NPI assigned
Apr 12, 2007
Organization subpart
Yes
Parent organization
PREVENTIVE MEDICINE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Ms. Mary J Delong, MM, RHIA
Title
Credentialing Manager
Phone
(413) 222-7711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

884 Washington St
2ND Floor
Weymouth, MA 02189-1530

Mailing address

884 Washington St
2ND Floor
Weymouth, MA 02189-1530
Phone (617) 447-2146

Other names 1

  • Weymouth Medical Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Springfield International Health Center29 organizations share this tax ID, including this one
Part of
Springfield International Health Center

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1669696530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 WASHINGTON ST",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021891530",
            "telephone_number": "617-447-2146",
            "fax_number": "617-259-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 WASHINGTON ST",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021891530",
            "telephone_number": "617-447-2146",
            "fax_number": "617-259-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "413-222-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MM, RHIA"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weymouth Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.