PREVENTIVE MEDICINE ASSOCIATES (NPI# 1528353612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528353612 |
| Entity Type | Organization |
| Organization Name | PREVENTIVE MEDICINE ASSOCIATES |
| Other Organization Name | LYNN HARBOR WELLNESS CENTER |
| Practice Address |
154 Lynnway Suite 1c Lynn MA 01902-3479 |
| Practice Telephone | 7815846106 |
| Mailing Telephone | 7815846106 |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |
| Authorized Official Name | MS. MARY J DELONG (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4132227711 |
| Authorized Official Credential | MM, RHIA |
| Is Organization Subpart | Y |
| Parent Organization Name | PREVENTIVE MEDICINE ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lynn Harbor Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659679793 | Preventive Medicine Associates | Family Medicine | 2201 Washington St, Suite 302, Roxbury, MA 02119-3212 | 2011-03-13 |
| 1568760601 | Preventive Medicine Associates | Family Medicine | 501b Washington St, Dorchester Center, MA 02124-2014 | 2011-03-13 |
| 1962705251 | Preventive Medicine Associates | Family Medicine | 9 Henshaw St, Brighton, MA 02135-2905 | 2010-12-08 |
| 1326350976 | Preventive Medicine Associates | Family Medicine | 360 Coggeshall St, New Bedford, MA 02746-1923 | 2010-07-12 |
| 1689900565 | Preventive Medicine Associates | Family Medicine | 322 Gifford St, Falmouth, MA 02540 | 2009-10-27 |
| 1962641159 | Preventive Medicine Associates | Family Medicine | 63 Winthrop St, # C1, C2, Taunton, MA 02780-6218 | 2009-02-11 |
| 1578702957 | Preventive Medicine Associates | Counselor | 3261 Main St, Barnstable, MA 02630-1105 | 2009-02-09 |
| 1356507511 | Preventive Medicine Associates | Family Medicine | 98 Suffolk St, Holyoke, MA 01040-4458 | 2008-08-06 |
| 1588093744 | Preventive Medicine Associates | Specialist | 1919 Sw 10th Ave, Suite 22, Topeka, KS 66604-1425 | 2013-11-07 |
| 1427360072 | Preventive Medicine Associates | Family Medicine | 451 Andover St, Suite 195, North Andover, MA 01845-5044 | 2010-07-12 |
| Street Address |
154 LYNNWAY SUITE 1C |
| City | LYNN |
| State | MA |
| Zip Code | 01902-3479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093291130 | Top Care Physical Therapy Rehab | Clinic/Center | 373 Chatham St # 2, Lynn, MA 01902 | 2018-07-12 |
| 1407343726 | Patricia De Leon | Developmental Therapist | 176 Franklin St., Lynn, MA 01902 | 2018-04-23 |
| 1578076725 | Janice S. Baltoumas | Dietitian, Registered | Element Care Inc., 37 Friend Street, Lynn, MA 01902 | 2017-11-09 |
| 1396263174 | Jayna Kathryn Doherty-kinloch | Social Worker | 31 Clark Street, Lynn, MA 01902 | 2017-08-31 |
| 1891219416 | Omobolanle O. Akinyemi | Licensed Practical Nurse | 9 Buffum St, Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1003330523 | Jessica Lee Crowley | Registered Nurse | 9 Buffum St., Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1689198228 | Shannon Gomatos | Registered Nurse | 20 School St., Lynn, MA 01902 | 2017-07-26 |
| 1578087193 | Josephine P. Cooke | Registered Nurse | 62 Market St., Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1316471568 | Ujunwa Okwukaogu | Registered Nurse | 118 Franklin Street #3, Lynn, MA 01902 | 2017-04-14 |
| 1033655501 | Francis Howard Crowley | Social Worker | 37 Friend Street, Element Care, Lynn, MA 01902 | 2017-01-09 |
| Find all providers in zip 01902 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578062758 | Robynne Brown | Family Medicine | 59 Coddington St Ste 103, Quincy, MA 02169-4510 | 2018-02-02 |
| 1659679793 | Preventive Medicine Associates | Family Medicine | 2201 Washington St, Suite 302, Roxbury, MA 02119-3212 | 2011-03-13 |
| 1568760601 | Preventive Medicine Associates | Family Medicine | 501b Washington St, Dorchester Center, MA 02124-2014 | 2011-03-13 |
| 1962705251 | Preventive Medicine Associates | Family Medicine | 9 Henshaw St, Brighton, MA 02135-2905 | 2010-12-08 |
| 1326350976 | Preventive Medicine Associates | Family Medicine | 360 Coggeshall St, New Bedford, MA 02746-1923 | 2010-07-12 |
| 1689900565 | Preventive Medicine Associates | Family Medicine | 322 Gifford St, Falmouth, MA 02540 | 2009-10-27 |
| 1962641159 | Preventive Medicine Associates | Family Medicine | 63 Winthrop St, # C1, C2, Taunton, MA 02780-6218 | 2009-02-11 |
| 1356507511 | Preventive Medicine Associates | Family Medicine | 98 Suffolk St, Holyoke, MA 01040-4458 | 2008-08-06 |
| 1194949073 | Vineyard Healthcare Assoc. | Family Medicine | 455 State Rd Ste 13, Vineyard Haven, MA 02568-5621 | 2007-04-12 |
| 1063585370 | John M F Costa | Family Medicine | 42 Lands End Way, Swansea, MA 02777-2910 | 2006-11-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PREVENTIVE MEDICINE ASSOCIATES.
| 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.