SRC Pittsfield Op, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SRC PITTSFIELD OP, LLC

Doing business as

Wingate Residences at Melbourne Place

Practice address

140 Melbourne Rd
Pittsfield, MA 01201-8533

Phone

(413) 499-1992

Fax

(413) 443-8870

NPI assigned

Nov 12, 2019

Organization subpart

No

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

Authorized official

Name

Jonathan Scharf

Title

General Counsel

Phone

(781) 707-9030

Specialties & licenses 1

Addresses

Other names 1

• Wingate Residences at Melbourne Place Doing business as

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1700421948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942760",
            "telephone_number": "781-707-9085",
            "fax_number": "781-281-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MELBOURNE RD",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012018533",
            "telephone_number": "413-499-1992",
            "fax_number": "413-443-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC PITTSFIELD OP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "SCHARF",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "781-707-9030"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wingate Residences at Melbourne Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark A. Sprague, M.D.
• Hannah Springer
• Margaret Springer
• Springfield Therapy LLC
• Jakleen Rose Squires
• SRC Pittsfield, LLC
• Kolala R Sridhar, MD
• Sundeep Srikakulam, M.D.
• Seema Srinivasa Raju, MD
• Jeffrey L St John, M.D.

• Assisted Living Facility in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.