Active NPI
Charles Thomas Kendrick, M.D., D.M.D.
- Anesthesiology Physician
- Brighton, MA
National Provider Identifier
1811977747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 82014
- Practice address
- 30 Warren St
Brighton, MA 02135-3602 - Phone
- (617) 254-3800
- Fax
- (617) 779-1509
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 82014 | MA | Primary |
Addresses
Primary practice location
30 Warren St
Brighton, MA 02135-3602
Mailing address
80 Hannah Niles Way
Braintree, MA 02184-7260
Phone (781) 356-2120
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82014 | MA | MD | Anesthesiology Physician |
Interoperability endpoints
- ckendrick190015@direct.bostonchildrens.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1811977747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 HANNAH NILES WAY",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021847260",
"telephone_number": "781-356-2120",
"fax_number": "781-356-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 WARREN ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353602",
"telephone_number": "617-254-3800",
"fax_number": "617-779-1509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "CHARLES",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D., D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "82014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.