NPIMap

Organization Active NPI

Beacon Primary Medicine, Inc.

  • Internal Medicine Physician
  • Lawrence, MA
National Provider Identifier
1790057404
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
78290 Issued in MA
Legal business name
BEACON PRIMARY MEDICINE, INC.
Practice address
50 Prospect St
Lawrence, MA 01841-2841
Phone
(617) 794-1463
Fax
(617) 739-1963
NPI assigned
Jan 27, 2012
Last updated
Jan 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Dr. Robin Stanton Mayfield, M.D.NPI 1225098924
Title
President
Phone
(617) 794-1463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 78290 MA Primary
Pediatrics Physician 208000000X 78290 MA

Addresses

Primary practice location

50 Prospect St
Lawrence, MA 01841-2841

Mailing address

50 Prospect St
Lawrence, MA 01841-2841
Phone (617) 794-1463

Other identifiers 3

IdentifierTypeStateIssuer
1225098924OtherMANPI
J14325OtherMEDICARE PROVIDER
F71191OtherUPIN

National Provider Directory

National Provider Directory
Tax ID family
Beacon Primary Medicine2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1790057404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PROSPECT ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412841",
            "telephone_number": "617-794-1463",
            "fax_number": "617-739-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PROSPECT ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412841",
            "telephone_number": "617-794-1463",
            "fax_number": "617-739-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PRIMARY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "STANTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-794-1463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "78290",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "78290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225098924",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "J14325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F71191",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.