NPIMap

Organization Active NPI

FBTC Transitional Sub, LLC

  • Community/Behavioral Health Agency
  • Beverly, MA
National Provider Identifier
1881283091
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FBTC TRANSITIONAL SUB, LLC
Practice address
55 Tozer Rd
Beverly, MA 01915-5515
Phone
(978) 969-2894
NPI assigned
Jan 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP& Sr Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Community/Behavioral Health Agency 251S00000X Primary
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

55 Tozer Rd
Beverly, MA 01915-5515

Mailing address

55 Tozer Rd
Beverly, MA 01915-5515
Phone (978) 969-2894

Other practice location 1

216 W Boylston St Ste 200
West Boylston, MA 01583-1788
Phone (508) 213-3355

Other identifiers 1

IdentifierTypeStateIssuer
110078808AMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
FBTC Transitional Sub LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

216 W Boylston St
Ste 200
West Boylston, MA 01583
Phone (508) 213-3355

618 Main St
Lewiston, ME 04240
Phone (207) 795-6110

3229 Argent Blvd
Ste A
Ridgeland, SC 29936

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1881283091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOZER RD",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155515",
            "telephone_number": "978-969-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TOZER RD",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155515",
            "telephone_number": "978-969-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 W Boylston St Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Boylston",
            "state": "MA",
            "postal_code": "015831788",
            "country_code": "US",
            "telephone_number": "508-213-3355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FBTC TRANSITIONAL SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP& SR ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110078808A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.