Active NPI
South End Community Health Center
- Urgent Care Clinic/Center
- Boston, MA
National Provider Identifier
1962792200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- License
- 4031
- Legal business name
- SOUTH END COMMUNITY HEALTH CENTER
- Practice address
- 1601 Washington St
Boston, MA 02118-1951 - Phone
- (617) 425-2000
- Fax
- (617) 424-8725
- NPI assigned
- Apr 7, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Johnson, SR
- Title
- Ceo
- Phone
- (617) 425-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | 4031 | MA | Primary |
Addresses
Primary practice location
1601 Washington St
Boston, MA 02118-1951
Mailing address
1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1301993 | Medicaid | MA | |
| 110009433B | Medicaid | MA |
National Provider Directory
National Provider Directory- Tax ID family
- South End Comm HLTH Ctr
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Student in an Organized Health Care Education/Training Program
- Boston, MA
- NPI 1649667809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1302134400000",
"number": "1962792200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181951",
"telephone_number": "617-425-2000",
"fax_number": "617-424-8725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181951",
"telephone_number": "617-425-2000",
"fax_number": "617-424-8725"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH END COMMUNITY HEALTH CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "617-425-2000",
"authorized_official_credential": "SR"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "MA",
"license": "4031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1301993",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110009433B",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
- South Cove Community Health Center, Inc.
- South Cove Community Health Center, Inc.
- South Cove Community Health Center, Inc.
- South Cove Community Health Center, Inc.
- South Cove Manor, Inc
- South End Community Health Center Inc
- South End Community Health Center Inc
- South End Dental Associates
- South End Skin Care, Inc.
- South Shore Eye Care, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.