NPIMap

Organization Active NPI

Codman Square Health Center, Inc

Doing business as Codman Square Health Center Urgent Care

  • Urgent Care Clinic/Center
  • Dorchester, MA
National Provider Identifier
1922599117
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CODMAN SQUARE HEALTH CENTER, INC
Doing business as
Codman Square Health Center Urgent Care
Practice address
637 Washington Street
Urgent Care Department
Dorchester, MA 02124-3510
Phone
(617) 822-8725
Fax
(617) 822-8244
NPI assigned
May 23, 2018
Organization subpart
Yes
Parent organization
CODMAN SQUARE HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Ms. Tarsha Weaver, COO
Title
Chief Operating Officer
Phone
(617) 822-8744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

637 Washington Street
Urgent Care Department
Dorchester, MA 02124-3510

Mailing address

637 Washington Street
Urgent Care Department
Dorchester, MA 02124-3510
Phone (617) 822-8725

Other identifiers 1

IdentifierTypeStateIssuer
110022129FMedicaidMA

Other names 1

  • Codman Square Health Center Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Codman Square Health Center4 organizations share this tax ID, including this one
Part of
Codman Square Health Center

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1922599117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON STREET",
            "address_2": "URGENT CARE DEPARTMENT",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-822-8725",
            "fax_number": "617-822-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON STREET",
            "address_2": "URGENT CARE DEPARTMENT",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-822-8725",
            "fax_number": "617-822-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODMAN SQUARE HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CODMAN SQUARE HEALTH CENTER",
        "enumeration_date": "2018-05-23",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "TARSHA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-822-8744",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110022129F",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Codman Square Health Center Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.