Codman Square Health Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CODMAN SQUARE HEALTH CENTER

Practice address

637 Washington St
Dorchester Center, MA 02124-3510

Phone

(617) 825-9660

NPI assigned

Jun 11, 2007

Organization subpart

No

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

Authorized official

Name

Jaiqi Tao

Title

Cfo

Phone

(617) 825-9660

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Codman Square Health Ce4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Codman Square Health Center

  • Community Health Clinic/Center
  • Randolph, MA
  • NPI 1003770736
  NPD tax ID
• Codman Square Health Center

  • Optometrist
  • Dorchester, MA
  • NPI 1437328648
  NPD tax ID
• Codman Square Health Center, Inc

  • Urgent Care Clinic/Center
  • Dorchester, MA
  • NPI 1922599117
  NPD tax ID

Locations

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801099346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODMAN SQUARE HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAO",
        "authorized_official_first_name": "JAIQI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-825-9660"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1211757",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chestnut Dermapathology Associates
• Carolyn Chu, MS, RD
• Gary Ciambrone, M.S. CCC-SLP
• Meghan Cobb, N.P.
• Codman Academy Charter School
• Codman Square Health Center Inc
• Commonwealth Care Alliance, Inc.
• Commonwealth Hematology-Oncology, PC
• Comprehensivedentalcare
• Christopher John Conroy

• Clinical Social Worker in Dorchester Center, MA
• Providers in Dorchester Center, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.