Bear Mt Stoughton LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BEAR MT STOUGHTON LLC

Practice address

1044 Park St
Stoughton, MA 02072-3762

Phone

(781) 344-7300

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

John Wynne Jr.

Title

Member/Cfo

Phone

(860) 880-8202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1972063782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST STE 203",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871741",
            "telephone_number": "860-880-8202",
            "fax_number": "860-880-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 PARK ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723762",
            "telephone_number": "781-344-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR MT STOUGHTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER/CFO",
        "authorized_official_telephone_number": "860-880-8202",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.