Active NPI
New Bedford Jewish Convalescent Home, Inc.
- Skilled Nursing Facility
- New Bedford, MA
National Provider Identifier
1710980792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 225481
- Legal business name
- NEW BEDFORD JEWISH CONVALESCENT HOME, INC.
- Practice address
- 200 Hawthorn St
New Bedford, MA 02740-2201 - Phone
- (508) 997-9314
- Fax
- (508) 996-3664
- NPI assigned
- May 24, 2005
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Carol A. Trudeau
- Title
- Administrator
- Phone
- (508) 997-9314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 225481 | MA | Primary |
Addresses
Primary practice location
200 Hawthorn St
New Bedford, MA 02740-2201
Mailing address
200 Hawthorn St
New Bedford, MA 02740-2201
Phone (508) 997-9314
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0998885 | Medicaid | MA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- New Bedford, MA
- NPI 1003859265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1710980792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWTHORN ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402201",
"telephone_number": "508-997-9314",
"fax_number": "508-996-3664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWTHORN ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402201",
"telephone_number": "508-997-9314",
"fax_number": "508-996-3664"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW BEDFORD JEWISH CONVALESCENT HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-24",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TRUDEAU",
"authorized_official_first_name": "CAROL",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "508-997-9314",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "225481",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0998885",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Bedford, MA
- New Bedford Dentistry and Braces PC
- New Bedford Health and Rehabilitation Center LLC (West End Rehabilitation and Nursing Center)
- New Bedford Health and Wellness Center (New England Spine and Disc Center of Massachusetts)
- New Bedford Health Department
- New Bedford Internal Medicine & Geriatrics, LLC
- New Bedford Management Systems, Inc (Hathaway Manor Extended Care Facility)
- New Bedford Medical Associates - Cardiac Billing
- New Bedford Medical Associates- Cardiology
- New Bedford Medical Investors LLC (The Oaks)
- New Bedford Pathology Associates, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.