Liberty Street Facility

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

59098 Issued in MA

Legal business name

LIBERTY STREET FACILITY

Practice address

125 Liberty St
Suite 206
Springfield, MA 01103-1114

Phone

(413) 746-4800

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

David M Chadbourne, MD

Title

Owner

Phone

(413) 746-4800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902963705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LIBERTY ST",
            "address_2": "SUITE 206",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031114",
            "telephone_number": "413-746-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LIBERTY ST",
            "address_2": "SUITE 206",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031114",
            "telephone_number": "413-746-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY STREET FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHADBOURNE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-746-4800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MA",
            "license": "59098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shan Li, MD
• Zhensheng Li
• Sybille M Liautaud, MD
• Susan Libbos, CNM
• Megan Libby
• Wendy Ann Libowitz, APRN
• Hannah Librot
• Tiffany M. Liddell
• Joshua Marc Lieberman
• Kelsey Leanne Lieberman

• Ambulatory Surgical Clinic/Center in Springfield, MA
• Providers in Springfield, MA by specialty
• Ambulatory Surgical Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.