SOUTH BOSTON COMMUNITY HEALTH CENTER (NPI# 1366626624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366626624 |
| Entity Type | Organization |
| Organization Name | SOUTH BOSTON COMMUNITY HEALTH CENTER |
| Practice Address |
409 W Broadway South Boston MA 02127-2245 |
| Practice Telephone | 6172697500 |
| Practice Fax Number | 6174647581 |
| Mailing Telephone | 6172697500 |
| Mailing Fax Number | 6174647581 |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2007-12-21 |
| Authorized Official Name | AKINOLA OGUNGBADERO (CFO) |
| Authorized Official Telephone | 6172697500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | MA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS DENTAL | X10787 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295221315 | South Boston Community Health Center | Clinic/Center | 409 W Broadway, South Boston, MA 02127-2245 | 2018-07-02 |
| 1952632663 | South Boston Community Health Center | Social Worker | 409 W Broadway, South Boston, MA 02127-2245 | 2010-01-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SOUTH BOSTON COMMUNITY HEALTH CENTER, INC. | 409 W. Broadway, So. Boston, MA 02127 |
| Street Address |
409 W BROADWAY |
| City | SOUTH BOSTON |
| State | MA |
| Zip Code | 02127-2245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023081841 | Pamela Cattel | Internal Medicine | 409 W Broadway, South Boston, MA 02127-2245 | 2006-02-10 |
| 1215411749 | Kelly Anne Maloy | Nurse Practitioner | 409 W Broadway, South Boston, MA 02127-2245 | 2018-09-20 |
| 1437633401 | Veronica Lynn Hecht | Nurse Practitioner | 409 W Broadway, South Boston, MA 02127-2245 | 2018-09-17 |
| 1295221315 | South Boston Community Health Center | Clinic/Center | 409 W Broadway, South Boston, MA 02127-2245 | 2018-07-02 |
| 1427581727 | Jonathan Foster | Dentist | 409 W Broadway, South Boston, MA 02127-2245 | 2017-04-04 |
| 1306377049 | Isabella Buzzo Bellon Brout | Family Medicine | 409 W Broadway, South Boston, MA 02127-2245 | 2017-03-24 |
| 1548706187 | Mary Mcpherson | Social Worker | 409 W Broadway, South Boston, MA 02127-2245 | 2017-01-06 |
| 1902269202 | Katrina Jeanette Ciraldo | Family Medicine | 409 W Broadway, South Boston, MA 02127-2245 | 2016-04-04 |
| 1518373752 | Elizabeth Temple Corridan | Nurse Practitioner | 409 W Broadway, South Boston, MA 02127-2245 | 2014-07-09 |
| 1861837254 | Quest Diagnostics Massachusetts LLC | Clinical Medical Laboratory | 409 W Broadway, South Boston, MA 02127-2245 | 2013-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370629 | Peaceful Healing Soul Counseling Center, LLC | Counselor | Online Therapy, Boston, MA 02127 | 2020-09-15 |
| 1568964914 | Phuong Luu | Nurse Practitioner | 606 E Fourth St, Unit 204, Boston, MA 02127 | 2018-03-01 |
| 1700304367 | Kelsey L Donovan | Physician Assistant | 431 E 3rd Street Apt 2, Boston, MA 02127 | 2017-09-05 |
| 1255873733 | Janet Villafane | Social Worker | 23 Mcdonough Way, 691, Boston, MA 02127 | 2016-11-15 |
| 1083088470 | Katie Ryan | Counselor | 8 Rev Burke Street #151, South Boston, MA 02127 | 2015-11-23 |
| 1184005514 | Keith A Lombard | Counselor | 1226a Columbia Rd., South Boston, MA 02127 | 2015-06-11 |
| 1609213917 | Nicole Ashley Vandermay | Student in an Organized Health Care Education/Training Program | 9 Woodward St, Apt. 3, Boston, MA 02127 | 2013-05-28 |
| 1922359777 | Elizabeth Raggi | Counselor | 49 L Street, South Boston, MA 02127 | 2012-09-19 |
| 1205181021 | Massachusetts General Hospital | General Acute Care Hospital | 256 West Sixth Street Apt 2, South Boston, MA 02127 | 2012-07-18 |
| 1154602126 | Madeline F Brisotti | Counselor | 8 Reverend Burke Steet, South Boston, MA 02127 | 2011-09-06 |
| Find all providers in zip 02127 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972004299 | Velocity Urgent Care, LLC | Clinic/Center | 3601 Old Halifax Rd, South Boston, VA 24592-4952 | 2018-02-22 |
| 1760740625 | Dominion Health Medical Assoc | Clinic/Center | 2206 Wilborn Ave, South Boston, VA 24592 | 2012-04-30 |
| 1801175567 | Dominion Health Medical Associates | Clinic/Center | 2232 Wilborn Ave, South Boston, VA 24592-1662 | 2011-08-12 |
| 1396079414 | Gavin Foundation | Clinic/Center | 49 L St, South Boston, MA 02127-1511 | 2009-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083221014 | The Wellness Point | Clinic/Center | 569a Springfield St, Feeding Hills, MA 01030-2105 | 2020-09-24 |
| 1629689153 | Be Well Medica, LLC | Clinic/Center | 38 Willard Grant Rd, Sudbury, MA 01776-1035 | 2020-08-10 |
| 1649896283 | Community Health Center of Cape Cod, Inc. | Clinic/Center | 90 Route 6a, Sandwich, MA 02563-5301 | 2020-06-19 |
| 1194344713 | Snooze Laboratories, Inc | Clinic/Center | 122 Chestnut St Apt 101, Springfield, MA 01103-1541 | 2020-04-14 |
| 1861024457 | Treehouse Center for Sensory Integration | Clinic/Center | 19 Muzzey St # L20, Lexington, MA 02421-5256 | 2020-02-11 |
| 1982262184 | Nationwide Health Advocates LLC | Clinic/Center | 5 Pleasant St Ste 1, Methuen, MA 01844-3195 | 2019-06-03 |
| 1538622436 | Onduo Professionals of Texas, P.a. | Clinic/Center | 55 Chapel St Ste 200, Newton, MA 02458-1070 | 2019-04-09 |
| 1801357454 | Kelly Dumay Pogeyed Tuguinay | Clinic/Center | 2 Mcdewell Ave Apt 17, Danvers, MA 01923-3335 | 2019-03-27 |
| 1760949192 | Elizabeth Apkin Psyd LLC | Clinic/Center | 1577 Beacon St Ste D, Brookline, MA 02446-4602 | 2019-02-21 |
| 1578027975 | Chinne Health Systems LLC | Clinic/Center | 330 Lynnway Ste 112, Lynn, MA 01901-1706 | 2019-01-30 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 02127 |
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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.