Active NPI
Thomas A. Fagan, DC
- Chiropractor
- South Boston, MA
National Provider Identifier
1790812352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2284
- Practice address
- 75 Dorchester St
South Boston, MA 02127-2228 - Phone
- (617) 464-2227
- Fax
- (617) 268-4218
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2284 | MA | Primary |
Addresses
Primary practice location
75 Dorchester St
South Boston, MA 02127-2228
Mailing address
75 Dorchester St
South Boston, MA 02127-2228
Phone (617) 464-2227
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 352504 | Other | MA | HARVARD PILGRIM HEALTH |
| Y36717 | Other | MA | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479686400000",
"number": "1790812352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 DORCHESTER ST",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021272228",
"telephone_number": "617-464-2227",
"fax_number": "617-268-4218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 DORCHESTER ST",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021272228",
"telephone_number": "617-464-2227",
"fax_number": "617-268-4218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "THOMAS",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2016-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "2284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH",
"identifier": "352504",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y36717",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.