Stoughton Street Chiropractic & Rehab, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MA 2213 Issued in MA

Legal business name

STOUGHTON STREET CHIROPRACTIC & REHAB, INC.

Practice address

19 Stoughton St
Dorchester, MA 02125-3402

Phone

(617) 379-3013

NPI assigned

Jan 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Brian C. Fahey, D.C.

Title

V.P.

Phone

(617) 379-3013

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1760629224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 STOUGHTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253402",
            "telephone_number": "617-379-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 STOUGHTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253402",
            "telephone_number": "617-379-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOUGHTON STREET CHIROPRACTIC & REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "FAHEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "617-379-3013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "MA 2213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "U68533",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "461056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MA.",
            "identifier": "Y36538",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.