NPIMap

Organization Active NPI

Southcoast Primary Care Inc

  • Family Medicine Physician
  • Mattapoisett, MA
National Provider Identifier
1891783189
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHCOAST PRIMARY CARE INC
Practice address
109 Fairhaven Road
Southcoast Primary Care Inc
Mattapoisett, MA 02739
Phone
(508) 758-3781
Fax
(508) 758-4455
NPI assigned
Oct 11, 2005
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Mary Hodgson
Title
Executive Director
Phone
(508) 985-2011

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

109 Fairhaven Road
Southcoast Primary Care Inc
Mattapoisett, MA 02739

Mailing address

370 Faunce Corner Rd
Southcoast Primary Care Inc
North Dartmouth, MA 02747
Phone (508) 985-2000

Other identifiers 3

IdentifierTypeStateIssuer
CE9725OtherMARAILROAD MEDICARE
9782036MedicaidMA
M16797OtherMABCBS MASSACHUSETTS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1891783189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 FAUNCE CORNER RD",
            "address_2": "SOUTHCOAST PRIMARY CARE INC",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-985-2000",
            "fax_number": "508-985-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FAIRHAVEN ROAD",
            "address_2": "SOUTHCOAST PRIMARY CARE INC",
            "city": "MATTAPOISETT",
            "state": "MA",
            "postal_code": "02739",
            "telephone_number": "508-758-3781",
            "fax_number": "508-758-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCOAST PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "HODGSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-985-2011"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE9725",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9782036",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MASSACHUSETTS",
            "identifier": "M16797",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapoisett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.