Sudbury Brook Mental Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SUDBURY BROOK MENTAL HEALTH LLC

Practice address

23 Village Rd
Sudbury, MA 01776-1337

Phone

(978) 793-5628

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Taixiang Saur, PMHNPNPI 1285296632

Title

Owner

Phone

(978) 793-5628

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Taixiang Saur, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Quincy, MA
  • NPI 1285296632
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1902558422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 VILLAGE RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761337",
            "telephone_number": "978-793-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 VILLAGE RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761337",
            "telephone_number": "978-793-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDBURY BROOK MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "SAUR",
        "authorized_official_first_name": "TAIXIANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-793-5628",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Sudbury, MA
• Providers in Sudbury, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.