North Shore Center for Orthopedic Surgery & Sports Medicine LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

NORTH SHORE CENTER FOR ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC

Practice address

4 State Rd
Danvers, MA 01923-2567

Phone

(978) 774-3400

Fax

(978) 774-5883

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Stacy M Peterson, D.O.NPI 1952416489

Title

Owner/Manager

Phone

(978) 774-3400

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Stacy Peterson, D.O.

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1952416489
  NPD Authorized official
• Douglas Edward Peterson, DO

  • Orthopaedic Surgery Physician
  • Danvers, MA
  • NPI 1477535896
  NPD

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1891447173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Highland Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019702702",
            "country_code": "US",
            "telephone_number": "978-745-0820",
            "fax_number": "978-745-5193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH SHORE CENTER FOR ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "978-774-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Joy Niven, OTR/L
• Grace Njoki
• William Richard Nolan Jr., DC
• Carys Nolin
• North Shore Center for Orthopedic Surgery
• North Shore Ear, Nose & Throat
• North Shore Ear, Nose & Throat Associates
• North Shore Ear, Nose and Throat Associates
• North Shore Elder Services, Inc.
• North Shore Elder Services, Inc.

• Orthopaedic Surgery Physician in Danvers, MA
• Providers in Danvers, MA by specialty
• Orthopaedic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.