NPIMap

Organization Active NPI

Haverhill Family Office, LLC

  • Internal Medicine Physician
  • Haverhill, MA
National Provider Identifier
1851935910
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HAVERHILL FAMILY OFFICE, LLC
Practice address
62 Brown St
Haverhill, MA 01830-6778
Phone
(978) 521-6555
Fax
(978) 521-1236
NPI assigned
Nov 1, 2019
Last updated
Apr 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Shiao-Ang Shih, MD
Title
Owner
Phone
(978) 521-6555

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

62 Brown St
Haverhill, MA 01830-6778

Mailing address

62 Brown St
Haverhill, MA 01830-6778
Phone (978) 521-6555

Other identifiers 1

IdentifierTypeStateIssuer
110159301AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191211002019 MA Part B Supplier - Clinic/Group Practice 2466885173 Receives reassigned benefits from 5 practitioners
Practice locations: Haverhill, MA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHAACD

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1851935910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306778",
            "telephone_number": "978-521-6555",
            "fax_number": "978-521-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306778",
            "telephone_number": "978-521-6555",
            "fax_number": "978-521-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERHILL FAMILY OFFICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "SHIH",
        "authorized_official_first_name": "SHIAO-ANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-521-6555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110159301A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.