NPIMap

Organization Active NPI

Javer, LLC

  • Skilled Nursing Facility
  • Lynn, MA
National Provider Identifier
1720074594
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0332 Issued in MA
Legal business name
JAVER, LLC
Doing business as
PHILLIPS MANOR NURSING HOME
Practice address
28 Linwood Rd
Lynn, MA 01905-1638
Phone
(781) 592-8000
Fax
(781) 598-1556
NPI assigned
Sep 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jalil Nassirzadeh
Title
Administrator/Owner
Phone
(781) 592-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0332 MA Primary

Addresses

Primary practice location

28 Linwood Rd
Lynn, MA 01905-1638

Mailing address

28 Linwood Rd
Lynn, MA 01905-1638
Phone (781) 592-8000

Other identifiers 1

IdentifierTypeStateIssuer
0925403MedicaidMA

Other names 1

  • PHILLIPS MANOR NURSING HOME Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720074594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 LINWOOD RD",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019051638",
            "telephone_number": "781-592-8000",
            "fax_number": "781-598-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 LINWOOD RD",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019051638",
            "telephone_number": "781-592-8000",
            "fax_number": "781-598-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NASSIRZADEH",
        "authorized_official_first_name": "JALIL",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "781-592-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925403",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILLIPS MANOR NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynn, MA

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.

Verify at the official NPI Registry.