NPIMap

Organization Active NPI

Carecentral Urgent Care Medical Group PC

Doing business as CareCentral Urgent Care

  • Urgent Care Clinic/Center
  • Stoughton, MA
National Provider Identifier
1679966022
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CARECENTRAL URGENT CARE MEDICAL GROUP PC
Doing business as
CareCentral Urgent Care
Practice address
286 Washington St
Stoughton, MA 02072-1763
Phone
(781) 341-2800
Fax
(781) 341-2828
NPI assigned
Mar 10, 2015
Last updated
Mar 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Dr. Renee Wilson, MDNPI 1740275403
Title
Owner
Phone
(718) 986-0110

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
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

286 Washington St
Stoughton, MA 02072-1763

Mailing address

682 Depot St
North Easton, MA 02356-2704
Phone (781) 341-2800

Other names 1

  • CareCentral Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001003237 MA DME Supplier - Physician - General Practice 5496907099 Practice locations: North Easton, MA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carecentral Urgent Care3 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.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1679966022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 DEPOT ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023562704",
            "telephone_number": "781-341-2800",
            "fax_number": "781-341-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 WASHINGTON ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721763",
            "telephone_number": "781-341-2800",
            "fax_number": "781-341-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECENTRAL URGENT CARE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-986-0110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareCentral Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.