Northeast Hospital Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTHEAST HOSPITAL CORPORATION

Practice address

85 Herrick Street
Medical Staff Office
Beverly, MA 01915

Phone

(978) 922-3000

Fax

(978) 921-7048

NPI assigned

Jun 27, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Denis Conroy

Title

Ceo

Phone

(978) 922-3000

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1871755132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK STREET",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK STREET",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "DENIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-922-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9709100",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "M19581",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Hospital Corporation (Spectrum Adult Day Health)
• Northeast Hospital Corporation
• Northeast Hospital Corporation (North Shore Birthing Center)
• Northeast Hospital Corporation
• Northeast Hospital Corporation
• Northeast Hospital Corportation
• Northeast Pho, Inc
• Northeast Professional Registry of Nurses Inc
• Northeast Senior Health Corp (Beverly Hospital Lifeline Program)
• Northshore Mobility & Wellness Concierge Physical Therapy

• Internal Medicine Physician in Beverly, MA
• Providers in Beverly, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.