NPIMap

Organization Active NPI

Docthor P.C.

  • Adult Mental Health Clinic/Center
  • Needham, MA
National Provider Identifier
1952708968
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
204123 Issued in MA
Legal business name
DOCTHOR P.C.
Practice address
75 2ND Ave.
Suite 310
Needham, MA 02494
Phone
(781) 726-6698
Fax
(617) 326-8314
NPI assigned
Nov 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Authorized official

Name
Dr. Thor Christian Bergersen, M.D.NPI 1013112796
Title
Medical Director
Phone
(781) 726-6698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 204123 MA Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 204123 MA

Addresses

Primary practice location

75 2ND Ave.
Suite 310
Needham, MA 02494

Mailing address

75 2ND Ave.
Suite 310
Needham, MA 02494
Phone (781) 726-6698

Other names 1

  • ADHD Boston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
ADHD Boston2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

75 2nd Ave
Ste 310
Needham, MA 02494
Phone (781) 726-6698

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1952708968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 2ND AVE.",
            "address_2": "SUITE 310",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02494",
            "telephone_number": "781-726-6698",
            "fax_number": "617-326-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 2ND AVE.",
            "address_2": "SUITE 310",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02494",
            "telephone_number": "781-726-6698",
            "fax_number": "617-326-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTHOR P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "BERGERSEN",
        "authorized_official_first_name": "THOR",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "781-726-6698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MA",
            "license": "204123",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MA",
            "license": "204123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADHD Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.