NPIMap

Organization Active NPI

Brockton Neighborhood Health Center

  • Health Maintenance Organization
  • Brockton, MA
National Provider Identifier
1770634776
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
1029174 Issued in MA
Legal business name
BROCKTON NEIGHBORHOOD HEALTH CENTER
Practice address
231 Main St FL 3
Brockton, MA 02301-4342
Phone
(508) 559-1567
Fax
(508) 559-5073
NPI assigned
Jan 16, 2007
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
Eleanor J Diethelm
Title
Social Worker
Phone
(508) 559-6699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 1029174 MA Primary

Addresses

Primary practice location

231 Main St FL 3
Brockton, MA 02301-4342

Mailing address

231 Main St FL 3
Brockton, MA 02301-4342
Phone (508) 559-1567

National Provider Directory

National Provider Directory
Tax ID family
Brockton Neighborhood Health Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770634776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST FL 3",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "508-559-1567",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN ST FL 3",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "508-559-1567",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON NEIGHBORHOOD HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIETHELM",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "508-559-6699"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MA",
            "license": "1029174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, 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.