Organization Active NPI

Community Coach, Inc,

  • Non-emergency Medical Transport (VAN)
  • Brockton, MA
National Provider Identifier
1780837427
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
COMMUNITY COACH, INC,
Practice address
25 Christy Dr
Brockton, MA 02301-1813
Phone
(508) 586-0700
Fax
(508) 586-0705
NPI assigned
Oct 28, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Miss Michelle A Castronovo, MANAGER
Title
Manager
Phone
(508) 586-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X MA Primary

Addresses

Primary practice location

25 Christy Dr
Brockton, MA 02301-1813

Mailing address

25 Christy Dr
Brockton, MA 02301-1813
Phone (508) 586-0700

Other identifiers 1

IdentifierTypeStateIssuer
1719378MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Community Coach Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780837427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHRISTY DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011813",
            "telephone_number": "508-586-0700",
            "fax_number": "508-586-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHRISTY DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011813",
            "telephone_number": "508-586-0700",
            "fax_number": "508-586-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COACH, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CASTRONOVO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "508-586-0700",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MANAGER"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1719378",
            "state": "MA"
        }
    ],
    "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 Jul 21, 2022; 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.