IHS of Massachusetts LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

IHS OF MASSACHUSETTS LLC

Doing business as

Advance Directions Renal Care Center

Practice address

1250 Hancock Street
Suite 204
Quincy, MA 02169

Phone

(617) 328-7707

Fax

(617) 328-7787

NPI assigned

Jul 6, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen McDonnell, RN, BSN

Title

President

Phone

(617) 328-7707

Specialties & licenses 1

Addresses

Other names 1

• Advance Directions Renal Care Center Doing business as

Locations

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1679860134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 BROKEN SOUND PKWY",
            "address_2": "SUITE 502",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872765",
            "telephone_number": "561-443-0743",
            "fax_number": "561-443-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK STREET",
            "address_2": "SUITE 204",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-328-7707",
            "fax_number": "617-328-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHS OF MASSACHUSETTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-328-7707",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Directions Renal Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Quincy, MA
• Providers in Quincy, MA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.