Active NPI
Kenneth A Machado
- Clinical Social Worker
- Fall River, MA
National Provider Identifier
1770636128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 205665
- Practice address
- 1563 North Main Street Suite 208
South Bay Mental Health Center
Fall River, MA 02720 - Phone
- (508) 324-1060
- Fax
- (508) 672-3619
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 205665 | MA | Primary |
Addresses
Primary practice location
1563 North Main Street Suite 208
South Bay Mental Health Center
Fall River, MA 02720
Mailing address
1380 Drift Rd
Westport, MA 02790
Phone (508) 636-4360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205665 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Bay Early Intervention | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Fall River, MA
- NPI 1841451705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770636128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1380 DRIFT RD",
"city": "WESTPORT",
"state": "MA",
"postal_code": "02790",
"telephone_number": "508-636-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1563 NORTH MAIN STREET SUITE 208",
"address_2": "SOUTH BAY MENTAL HEALTH CENTER",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "02720",
"telephone_number": "508-324-1060",
"fax_number": "508-672-3619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHADO",
"first_name": "KENNETH",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "205665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.