NPIMap

Organization Active NPI

Springfield International Health Center

  • Addiction Medicine (Family Medicine) Physician
  • Brookline, MA
National Provider Identifier
1750562765
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
SPRINGFIELD INTERNATIONAL HEALTH CENTER
Practice address
11 Kent St
Brookline, MA 02445-7901
Phone
(617) 383-6567
Fax
(617) 383-6664
NPI assigned
Nov 19, 2007
Last updated
Nov 19, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
PREVENTIVE MEDICINE ASSOCIATES,INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Authorized official

Name
Dr. Punyamurtula S Kishore, M.D.
Title
President
Phone
(617) 383-6567

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Addiction Medicine (Family Medicine) Physician 207QA0401X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

11 Kent St
Brookline, MA 02445-7901

Mailing address

760 Chestnut St
Springfield, MA 01107-1614
Phone (413) 214-7486

National Provider Directory

National Provider Directory
Tax ID family
Springfield International Health Center29 organizations share this tax ID, including this one
Part of
Springfield International Health Center

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

11 Kent St
Brookline, MA 02445
Phone (617) 383-6405

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDBAAA

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1750562765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071614",
            "telephone_number": "413-214-7486",
            "fax_number": "413-214-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KENT ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457901",
            "telephone_number": "617-383-6567",
            "fax_number": "617-383-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD INTERNATIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREVENTIVE MEDICINE ASSOCIATES,INC",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "KISHORE",
        "authorized_official_first_name": "PUNYAMURTULA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-383-6567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.