NPIMap

Organization Active NPI

Steven R. Kanner, MD, LLC

  • Internal Medicine Physician
  • Waltham, MA
National Provider Identifier
1679603757
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36451 Issued in MA
Legal business name
STEVEN R. KANNER, MD, LLC
Practice address
210 Bear Hill Rd
Suite 304
Waltham, MA 02451-1025
Phone
(781) 684-0600
Fax
(781) 684-0601
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Dr. Steven R. Kanner, MD
Title
Sole Member
Phone
(781) 684-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 36451 MA Primary

Addresses

Primary practice location

210 Bear Hill Rd
Suite 304
Waltham, MA 02451-1025

Mailing address

210 Bear Hill Rd
Suite 304
Waltham, MA 02451-1025
Phone (781) 684-0600

National Provider Directory

National Provider Directory

Locations

210 Bear Hill Rd
Ste 304
Waltham, MA 02451
Phone (781) 684-0600

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1679603757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL RD",
            "address_2": "SUITE 304",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511025",
            "telephone_number": "781-684-0600",
            "fax_number": "781-684-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL RD",
            "address_2": "SUITE 304",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511025",
            "telephone_number": "781-684-0600",
            "fax_number": "781-684-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. KANNER, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "KANNER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "781-684-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "36451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.