NPIMap

Organization Active NPI

Southcoast Physicians Group, Inc.

  • Speech-Language Pathologist
  • Fairhaven, MA
National Provider Identifier
1750869681
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SOUTHCOAST PHYSICIANS GROUP, INC.
Practice address
200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone
(508) 973-2000
Fax
(508) 973-2001
NPI assigned
Aug 2, 2018
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Heather Nesby
Title
Manager, Payer Credentialing
Phone
(508) 973-7014

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other identifiers 3

IdentifierTypeStateIssuer
CD2506OtherMARAILROAD MEDICARE
110072422AMedicaidMA
BM20689MedicaidRI

Other names 1

  • Southcoast - Tufts Health Plan Other name

National Provider Directory

National Provider Directory
Tax ID family
Southcoast Physician GRP in13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1750869681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCOAST PHYSICIANS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "NESBY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "MANAGER, PAYER CREDENTIALING",
        "authorized_official_telephone_number": "508-973-7014"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD2506",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072422A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BM20689",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southcoast - Tufts Health Plan",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southcoast - Tufts Health Plan",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairhaven, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.