NPIMap

Organization Active NPI

City of Peabody

  • Adult Day Care Clinic/Center
  • Peabody, MA
National Provider Identifier
1861531725
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
CITY OF PEABODY
Doing business as
Roger B. Trask Adult Day Health
Practice address
79 Central St
Peabody, MA 01960-4353
Phone
(978) 531-2254
Fax
(978) 531-7176
NPI assigned
Feb 6, 2007
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
Mrs. Kristin Crockett, M.S.G.
Title
Program Coordinator
Phone
(978) 531-2254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X MA Primary

Addresses

Primary practice location

79 Central St
Peabody, MA 01960-4353

Mailing address

79 Central St
Peabody, MA 01960-4353
Phone (978) 531-2254

Other identifiers 1

IdentifierTypeStateIssuer
1902121MedicaidMA

Other names 1

  • Roger B. Trask Adult Day Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
City of Peabody3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

79 Central St
Peabody, MA 01960
Phone (978) 531-2254

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861531725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 CENTRAL ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604353",
            "telephone_number": "978-531-2254",
            "fax_number": "978-531-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 CENTRAL ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604353",
            "telephone_number": "978-531-2254",
            "fax_number": "978-531-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PEABODY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "978-531-2254",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.G."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902121",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roger B. Trask Adult Day Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peabody, 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.