Beverly Pediatric Assoicates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23184 Issued in MA

Legal business name

BEVERLY PEDIATRIC ASSOICATES

Practice address

75 Herrick St
Suite 116
Beverly, MA 01915

Phone

(978) 922-3208

Fax

(978) 927-7429

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William R Dorsey, MD

Title

Owner MD

Phone

(978) 922-3208

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912031568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 116",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-922-3208",
            "fax_number": "978-927-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 116",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-922-3208",
            "fax_number": "978-927-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY PEDIATRIC ASSOICATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DORSEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER MD",
        "authorized_official_telephone_number": "978-922-3208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "23184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9779906",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Hospital
• Beverly Independent Eye Care, Inc.
• Beverly M. Shafer, MD
• Beverly Pathology Associates, Inc.
• Beverly Pathology Associates, P.C.
• Beverly Pediatrics Association
• Beverly Podiatry Inc. (Timothy Tobin D.P.M.)
• Beverly Podiatry, Inc
• Beverly Radiology Associates, Inc.
• Beverly School for the Deaf (The Childrens Center for Communication)

• Pediatrics Physician in Beverly, MA
• Providers in Beverly, MA by specialty
• Pediatrics Physician 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.