Tewksbury Medical Group, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

202775 Issued in MA

Legal business name

TEWKSBURY MEDICAL GROUP, P.C.

Practice address

600 Clark Rd
Tewksbury, MA 01876-1699

Phone

(978) 458-6900

Fax

(978) 458-1670

NPI assigned

Mar 8, 2006

Last updated

Mar 27, 2008By 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

Mrs. Carolyn Haskell, D.O.

Title

President

Phone

(978) 458-6900

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1811964877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-458-6900",
            "fax_number": "978-458-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-458-6900",
            "fax_number": "978-458-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEWKSBURY MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "HASKELL",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-458-6900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "202775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18372",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9731580",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Teta, RPH
• Tewksbury Assisted Living, LLC (The Isle at Emerald Court)
• Tewksbury Dental Associates (Drs. Cooper, Spiller and Nahata)
• Tewksbury Family Dental, LLC
• Tewksbury Living Group, LLC (Wood Haven)
• Tewksbury Psychiatry and Ketamine PLLC
• The Commonwealth of Massachusetts (State Office for Pharmacy Services (SOPS))
• The Commonwealth of Massachusetts (Tewksbury Hospital)
• The North East Educational and Developmental Support Center
• Therafit-Tewksbury, Inc.

• Family Medicine Physician in Tewksbury, MA
• Providers in Tewksbury, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.