Active NPI
Grace Johannette Mushrush, M.D.
- Psychiatry Physician
- Brockton, MA
National Provider Identifier
1932209756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35147
- Practice address
- 940 Belmont St
Brockton, MA 02301-5596 - Phone
- (617) 244-7589
- Fax
- (617) 965-4142
- NPI assigned
- Sep 22, 2006
- Last updated
- Jun 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 35147 | MA | |
| Psychiatry Physician | 2084P0800X | 35147 | MA | Primary |
| Geriatric Psychiatry Physician | 2084P0805X | 35147 | MA | |
| Psychosomatic Medicine Physician | 2084P0015X | 35147 | MA |
Addresses
Primary practice location
940 Belmont St
Brockton, MA 02301-5596
Mailing address
940 Belmont St
Brockton, MA 02301-5596
Phone (508) 583-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35147 | MA | MD | Psychosomatic Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantic Counseling and Consultation, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- South Weymouth, MA
- NPI 1285729004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1932209756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "508-583-4500",
"fax_number": "774-826-1859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "617-244-7589",
"fax_number": "617-965-4142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSHRUSH",
"first_name": "GRACE",
"middle_name": "JOHANNETTE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "35147",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "35147",
"primary": true
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "MA",
"license": "35147",
"primary": false
},
{
"code": "2084P0015X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychosomatic Medicine",
"state": "MA",
"license": "35147",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.