NPIMap

Organization Active NPI

Congenial Healthcare, LLC

Doing business as Gordon College Health Center

  • Student Health Clinic/Center
  • Wenham, MA
National Provider Identifier
1972155422
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CONGENIAL HEALTHCARE, LLC
Doing business as
Gordon College Health Center
Practice address
255 Grapevine Rd
Wenham, MA 01984
Phone
(978) 536-0215
Fax
(978) 536-0230
NPI assigned
Jul 15, 2019
Last updated
Jul 17, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CONGENIAL HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Lisa Marie Enderle
Title
Enrollment Manager
Phone
(978) 712-1681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

255 Grapevine Rd
Wenham, MA 01984

Mailing address

1 Roosevelt Ave
Peabody, MA 01960-2200
Phone (978) 536-0215

Other names 1

  • Gordon College Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Congenial Healthcare LLC7 organizations share this tax ID, including this one
Part of
Congenial Healthcare LLC

Other organizations with this tax ID 6

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

Locations

255 Grapevine Rd
Wenham, MA 01984
Phone (978) 524-0000

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1972155422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602200",
            "telephone_number": "978-536-0215",
            "fax_number": "978-536-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 GRAPEVINE RD",
            "city": "WENHAM",
            "state": "MA",
            "postal_code": "01984",
            "telephone_number": "978-536-0215",
            "fax_number": "978-536-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGENIAL HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONGENIAL HEALTHCARE, LLC",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "ENDERLE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "978-712-1681"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gordon College Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gordon College Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wenham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.