Organization Active NPI

Central Mass Dermatology PC

  • Procedural Dermatology Physician
  • Southbridge, MA
National Provider Identifier
1730339284
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
Legal business name
CENTRAL MASS DERMATOLOGY PC
Practice address
222 Main Street
Southbridge, MA 01550-2593
Phone
(508) 765-7711
Fax
(508) 765-7713
NPI assigned
Sep 21, 2008
Last updated
Aug 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Ms. Kathryn E Swanson, FNPNPI 1437216546
Title
Owner
Phone
(508) 765-7711

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 178544 MA
Procedural Dermatology Physician 207NS0135X Primary

Addresses

Primary practice location

222 Main Street
Southbridge, MA 01550-2593

Mailing address

222 Main Street
Southbridge, MA 01550-2593
Phone (508) 765-7711

Other identifiers 1

IdentifierTypeStateIssuer
110081099AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090116000138 MA Part B Supplier - Clinic/Group Practice 7416010434 Receives reassigned benefits from 5 practitioners
Practice locations: Southbridge, MA

National Provider Directory

National Provider Directory

Locations

9 Centennial Dr
Unit 202
Peabody, MA 01960
Phone (978) 209-9391

222 Main St
Southbridge, MA 01550
Phone (508) 764-2758

84 Myron St
West Springfield, MA 01089
Phone (203) 998-6678

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1730339284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502593",
            "telephone_number": "508-765-7711",
            "fax_number": "508-765-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MAIN STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502593",
            "telephone_number": "508-765-7711",
            "fax_number": "508-765-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MASS DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-21",
        "last_updated": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-765-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "178544",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110081099A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.