NPIMap

Organization Active NPI

Danvers Family Doctors, PC

  • Family Medicine Physician
  • Peabody, MA
National Provider Identifier
1902903115
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DANVERS FAMILY DOCTORS, PC
Practice address
1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227
Phone
(978) 762-6262
Fax
(978) 750-8312
NPI assigned
Sep 20, 2006
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Mrs. Donna Benton
Title
Office Manager
Phone
(978) 762-6262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA Primary

Addresses

Primary practice location

1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227

Mailing address

1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227
Phone (978) 762-6262

Other identifiers 1

IdentifierTypeStateIssuer
9723480MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000185 MA Part B Supplier - Clinic/Group Practice 9032153895 Receives reassigned benefits from 5 practitioners
Practice locations: Peabody, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0885989Danvers Family Doctors, PC1 Roosevelt Ave, Peabody, MA 01960Certificate of waiverSep 14, 2027

National Provider Directory

National Provider Directory

Locations

140 Commonwealth Ave
Ste 202
Danvers, MA 01923
Phone (978) 762-6262

1 Roosevelt Ave
Ste 204
Peabody, MA 01960
Phone (978) 536-7778

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11783/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1902903115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-762-6262",
            "fax_number": "978-750-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-762-6262",
            "fax_number": "978-750-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVERS FAMILY DOCTORS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "978-762-6262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9723480",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.