NPIMap

Organization Active NPI

Neurological Diagnostic and Treatment Center Inc

  • Neurology Physician
  • Pittsfield, MA
National Provider Identifier
1942311949
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGICAL DIAGNOSTIC AND TREATMENT CENTER INC
Practice address
276 South St
Pittsfield, MA 01201-6835
Phone
(413) 499-5888
Fax
(413) 499-3337
NPI assigned
Aug 31, 2006
Last updated
Feb 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Authorized official

Name
Mr. Keith Robert Edwards, MD
Title
Ceo
Phone
(802) 447-7577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

276 South St
Pittsfield, MA 01201-6835

Mailing address

160 Benmont Ave
Suite 25
Bennington, VT 05201-1873
Phone (802) 447-7577

Other identifiers 1

IdentifierTypeStateIssuer
9730265MedicaidMA

National Provider Directory

National Provider Directory

Locations

160 Benmont Ave
Ste 25
Bennington, VT 05201
Phone (802) 442-0158

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1942311949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BENMONT AVE",
            "address_2": "SUITE 25",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011873",
            "telephone_number": "802-447-7577",
            "fax_number": "802-447-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 SOUTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016835",
            "telephone_number": "413-499-5888",
            "fax_number": "413-499-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL DIAGNOSTIC AND TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-447-7577",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9730265",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.