NPIMap

Organization Active NPI

Caritas Good Samaritan Medical Center-Impatient Gero Psych

  • Psychiatric Hospital Unit
  • Brockton, MA
National Provider Identifier
1689763948
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
CARITAS GOOD SAMARITAN MEDICAL CENTER-IMPATIENT GERO PSYCH
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-3668
NPI assigned
Oct 12, 2006
Last updated
May 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Robert Guyon
Title
Office Contact
Phone
(508) 427-2217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

77 Warren Street
Provider Enrollment Dept
Brighton, MA 02135
Phone (617) 562-5359

Other identifiers 1

IdentifierTypeStateIssuer
1008595MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Steward Good Sam Med Ctr3 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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1689763948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN STREET",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-562-5359",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS GOOD SAMARITAN MEDICAL CENTER-IMPATIENT GERO PSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "GUYON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OFFICE CONTACT",
        "authorized_official_telephone_number": "508-427-2217"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008595",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.