FENWAY COMMUNITY HEALTH CENTER, INC (NPI# 1073744611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073744611 |
| Entity Type | Organization |
| Organization Name | FENWAY COMMUNITY HEALTH CENTER, INC |
| Practice Address |
1340 Boylston St 6th Floor Boston MA 02215-4302 |
| Practice Telephone | 6179276479 |
| Practice Fax Number | 6179276150 |
| Mailing Telephone | 6179276479 |
| Mailing Fax Number | 6179276150 |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |
| Authorized Official Name | MS. KARA ROBERTS (ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 6179276479 |
| Is Organization Subpart | Y |
| Parent Organization Name | FENWAY HEALTH OPTOMETRY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110020739B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982995197 | Fenway Community Health Center, Inc | Clinic/Center | 142 Berkeley St, Boston, MA 02116-5100 | 2011-04-21 |
| 1548589047 | Fenway Community Health Center, Inc | Clinic/Center | 75 Kneeland St, 2nd Floor, Boston, MA 02111-1901 | 2010-05-24 |
| 1275647505 | Fenway Community Health Center, Inc | Pharmacist | 1340 Boylston St, Boston, MA 02215-4302 | 2006-08-17 |
| 1003804725 | Fenway Community Health Center, Inc | Clinic/Center | 1340 Boylston St, Boston, MA 02215-4302 | 2005-10-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FENWAY COMMUNITY HEALTH CENTER, INC. | 1340 Boylston St, Boston, MA 02215-4302 |
| Street Address |
1340 BOYLSTON ST 6TH FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477541217 | Stephen Louis Boswell | Internal Medicine | 1340 Boylston St, Boston, MA 02215-4302 | 2005-10-06 |
| 1629681762 | Yvette Leblanc | Counselor | 1340 Boylston St, Boston, MA 02215-4302 | 2020-08-28 |
| 1689299521 | Simonne Katz | Social Worker | 1340 Boylston St, Boston, MA 02215-4302 | 2020-06-16 |
| 1922622992 | Emily Price | Social Worker | 1340 Boylston St, Boston, MA 02215-4302 | 2020-06-04 |
| 1962021931 | Emily F Thomas | Student in an Organized Health Care Education/Training Program | 1340 Boylston St, Boston, MA 02215-4302 | 2020-04-10 |
| 1720616303 | Dena Anne Shuster | Student in an Organized Health Care Education/Training Program | 1340 Boylston St, Boston, MA 02215-4302 | 2020-03-30 |
| 1427688282 | Annie Lynn Crossman | Counselor | 1340 Boylston St, Boston, MA 02215-4302 | 2020-01-21 |
| 1902452022 | Sophia Turner Axtman | Nurse Practitioner | 1340 Boylston St, Boston, MA 02215-4302 | 2019-08-14 |
| 1063065290 | Christina M King | Social Worker | 1340 Boylston St, Boston, MA 02215-4302 | 2019-07-17 |
| 1912563180 | Julian Allroth Dormitzer | Nurse Practitioner | 1340 Boylston St, Boston, MA 02215-4302 | 2019-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386120244 | Cumberland Family Medical Center, Inc. | Clinic/Center | 130 Wilson Creek Rd, Boston, KY 40107-8554 | 2018-07-13 |
| 1780827394 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 112 Southampton St, Boston, MA 02118 | 2009-04-13 |
| 1871736488 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 39 Boylston St Fl 2, Boston, MA 02116 | 2009-04-13 |
| 1205080355 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 363 Albany St, Boston, MA 02118-2503 | 2008-11-14 |
| 1558310052 | South End Community Health Center Inc | Clinic/Center | 1601 Washington Street, Boston, MA 02118 | 2006-05-10 |
| 1174012926 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 780 Albany St, Boston, MA 02118-2755 | 2018-05-08 |
| 1124259056 | Fenway Health | Clinic/Center | 1340 Boylston St, Boston, MA 02215-4302 | 2009-07-27 |
| 1245473859 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 55 Fruit St, Wacc 108, Boston, MA 02114 | 2009-04-13 |
| 1063655678 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 17 Court St, Boston, MA 02108 | 2009-04-13 |
| 1205080348 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 444 Harrison Ave, Boston, MA 02118 | 2008-11-14 |
| Find all providers in BOSTON | ||||
Please comment or provide details below to improve the information on FENWAY COMMUNITY HEALTH CENTER, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.