Kirkwood House Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0318 Issued in MA

Legal business name

KIRKWOOD HOUSE INC

Doing business as

Kirkwood Nursing Home

Practice address

202 Main St
Wakefield, MA 01880-1823

Phone

(781) 245-4129

Fax

(781) 245-7190

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Bethan Wells

Title

Administrator

Phone

(781) 245-4129

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kirkwood Nursing Home Doing business as

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922089440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801823",
            "telephone_number": "781-245-4129",
            "fax_number": "781-245-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801823",
            "telephone_number": "781-245-4129",
            "fax_number": "781-245-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKWOOD HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "BETHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "781-245-4129",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VACCINE IMMUNIZATION",
            "identifier": "20464",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0999091",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kirkwood Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Julia Stephanie King, PA-C
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• Skilled Nursing Facility in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Skilled Nursing Facility 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.