Jerry Wacks, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

28783 Issued in MA

Legal business name

JERRY WACKS, MD

Practice address

35 Bedford St
Suite 1
Lexington, MA 02420-4320

Phone

(781) 862-6767

Fax

(781) 861-6953

NPI assigned

Aug 9, 2007

Last updated

Aug 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Wacks

Title

Owner

Phone

(781) 861-6767

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1801087226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BEDFORD ST",
            "address_2": "SUITE 1",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204320",
            "telephone_number": "781-862-6767",
            "fax_number": "781-861-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BEDFORD ST",
            "address_2": "SUITE 1",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204320",
            "telephone_number": "781-862-6767",
            "fax_number": "781-861-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY WACKS, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "WACKS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-861-6767",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3999",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1023844",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110987",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "28783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Jean, LPN
• Kathryn Marie Jemas, PT, DPT
• Patricia Jenkins, OTR/L
• Haley Jenkinson, RN
• Jennie Steinberg LMHC LLC
• JG Home Health Care Services LLC (Interim HealthCare Inc)
• JG Therapy LLC
• Jgtherapy
• Shivkumar H Jha, MD
• Ke Jiang

• Psychiatry Physician in Lexington, MA
• Providers in Lexington, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.