SOUTHCOAST PHYSICIANS GROUP, INC. (NPI# 1235646332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235646332 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST PHYSICIANS GROUP, INC. |
| Other Organization Name | SOUTHCOAST URGENT CARE - FALL RIVER |
| Practice Address |
374 William S Canning Blvd Fall River MA 02721-2352 |
| Mailing Address |
200 Mill Rd Ste 180 Fairhaven MA 02719-5255 |
| Practice Telephone | 5089732432 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | KIMBERLEY COON (DIRECTOR, MEDICAL STAFF SVCS) |
| Authorized Official Telephone | 5089732432 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MA | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | MA | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | MA | Allopathic & Osteopathic Physicians | |
| N | 208M00000X | Hospitalist | MA | Allopathic & Osteopathic Physicians | |
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | MEDICAID | BM20689 | 01 |
| MA | 110072422A | 05 | |
| MA | RAILROAD MEDICARE | CD2506 | 01 |
| RI | MEDICARE | 709004034 | 01 |
| MA | MEDICARE | M20518 | 01 |
| Other Name | Type Code |
|---|---|
| Southcoast Urgent Care - Fall River | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841787652 | Southcoast Physicians Group, Inc. | Family Medicine | 670 Aquidneck Avenue, Middletown, RI 02841 | 2018-04-17 |
| 1770090870 | Southcoast Physicians Group, Inc. | Family Medicine | 636 County St, Taunton, MA 02780-3604 | 2018-01-10 |
| 1134664253 | Southcoast Physicians Group, Inc. | Family Medicine | 435 State Rd, Unit F, North Dartmouth, MA 02747-4306 | 2016-12-28 |
| 1306381421 | Southcoast Physicians Group, Inc. | Family Medicine | 37 Commerce Way, Seekonk, MA 02771-5816 | 2016-12-28 |
| 1336137629 | Southcoast Physicians Group, Inc. | Internal Medicine | 200 Mill Road, Suite 180, Fairhaven, MA 02719-5252 | 2005-10-11 |
| 1750869681 | Southcoast Physicians Group, Inc. | Audiologist | 200 Mill Rd Ste 180, Fairhaven, MA 02719-5255 | 2018-08-02 |
| 1700393808 | Southcoast Physicians Group, Inc. | Family Medicine | 12 Main St, Lakeville, MA 02347-1606 | 2018-01-10 |
| 1619413150 | Southcoast Physicians Group, Inc. | Family Medicine | 2421 Cranberry Hwy, Wareham, MA 02571-5021 | 2017-01-09 |
| 1346634052 | Southcoast Physicians Group, Inc. | Internal Medicine | 1030 President Ave, Suite 110, Fall River, MA 02720-5923 | 2015-03-20 |
| 1225421118 | Southcoast Physicians Group, Inc. | Physical Therapist | 479 Swansea Mall Dr, Swansea, MA 02777-4119 | 2015-03-17 |
| Street Address |
374 WILLIAM S CANNING BLVD |
| City | FALL RIVER |
| State | MA |
| Zip Code | 02721-2352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139703 | Ervin Pejo | Dentist | 824 William S Canning Blvd A, Fall River, MA 02721 | 2020-09-18 |
| 1316561814 | Sravanthi Tapal | Dentist | 45 Mariano South, Mariano Bishop Blvd, Fallriver, MA 02721 | 2020-06-01 |
| 1447808811 | Guilbert Maria | Dentist | 45 Mariano South, Mariano Bishop Blvd, Fall River, MA 02721 | 2019-08-29 |
| 1619466638 | Alpha Dental Center, P.c | Dentist | 516 Newton St., Fall River, MA 02721 | 2018-05-04 |
| 1083987374 | Fall River Dental Center | Dentist | 516 Newton St, Fall River, MA 02721 | 2012-02-16 |
| 1033489109 | Phoenix Psychiatric Services | Clinic/Center | 101 Jeremiah Sullivan Dr, Fall River, MA 02721 | 2012-01-06 |
| 1619271491 | Amanda Leigh Sims | Student in an Organized Health Care Education/Training Program | 1575 North Main Street, Fall River, MA 02721 | 2011-01-07 |
| 1346481280 | Paul Ongulo | Counselor | 170 Pleasant Street, Fall River, MA 02721 | 2009-03-23 |
| 1508020439 | Dental Dreams LLC | Dentist | 45 Mariano South Bishop Blvd, Fall River, MA 02721 | 2008-07-10 |
| 1174793244 | Joan P Riley | Social Worker | 700 Shore Dr Unit 605, Fall River, MA 02721 | 2008-03-05 |
| Find all providers in zip 02721 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114060506 | Michael A Pellegrino | Emergency Medicine | Charlton Memorial Hosp, Fall River, MA 00000 | 2007-02-15 |
| 1568557734 | Arthur Calvin Carter | Emergency Medicine | 363 Highland Ave., Charlton Hospital -south Coast Hospital, Fall River, MA 02720 | 2006-10-04 |
| 1326086257 | Jonathan Nelson Tweed | Emergency Medicine | 158 Wellington St, No. 10, Fall River, MA 02720-2958 | 2006-06-03 |
| 1023089695 | Neill Sinclair Barber | Emergency Medicine | 1030 President Ave Rm 210, Fall River, MA 02720-5929 | 2006-01-31 |
| 1811549231 | Kerry Maccini | Emergency Medicine | 795 Middle St, Fall River, MA 02721-1798 | 2019-07-15 |
| 1245686344 | Pooja Aysola | Emergency Medicine | 795 Middle St, Fall River, MA 02721 | 2016-05-06 |
| 1487051025 | Maya Grace Bouchard | Emergency Medicine | 795 Middle St, Fall River, MA 02721-1733 | 2014-11-25 |
| 1144660622 | Joseph Matthew Manchester | Emergency Medicine | 795 Middle St, Fall River, MA 02721-1733 | 2013-06-28 |
| 1811255821 | Peter Alonzo Kirk | Emergency Medicine | 363 Highland Ave, Emergency Department, Fall River, MA 02720-3703 | 2012-04-26 |
| 1952595761 | Christa Lynn Johnson | Emergency Medicine | 363 Highland Ave, Fall River, MA 02720-3703 | 2007-09-05 |
| Find all providers in FALL RIVER | ||||
| City | FALL RIVER |
| Zip Code | 02721 |
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| 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.