NPIMap

Organization Active NPI

Northeast Physician Practice

  • Specialist
  • Lynn, MA
National Provider Identifier
1841228632
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHEAST PHYSICIAN PRACTICE
Practice address
225 Boston St
Suite 205
Lynn, MA 01904-3137
Phone
(781) 595-4544
Fax
(781) 581-3740
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kim Rouillard
Title
Credentialing Manager
Phone
(978) 818-6110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

225 Boston St
Suite 205
Lynn, MA 01904-3137

Mailing address

PO Box 2149
Nemso
Danvers, MA 01923-5149
Phone (978) 818-6110

Other names 1

  • OB/GYN Associates Doing business as

National Provider Directory

National Provider Directory

Locations

225 Boston St
Ste 205
Lynn, MA 01904
Phone (781) 595-4544

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841228632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2149",
            "address_2": "NEMSO",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019235149",
            "telephone_number": "978-818-6110",
            "fax_number": "978-818-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BOSTON ST",
            "address_2": "SUITE 205",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019043137",
            "telephone_number": "781-595-4544",
            "fax_number": "781-581-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHYSICIAN PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROUILLARD",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "978-818-6110"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OB/GYN Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynn, MA

Sources for this page

  • 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.