MEDFORD ADHC (NPI# 1932566056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932566056 |
| Entity Type | Organization |
| Organization Name | MEDFORD ADHC |
| Practice Address |
101 Mystic Ave Medford MA 02155-4628 |
| Practice Telephone | 6178398299 |
| Mailing Telephone | 6178398299 |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-20 |
| Authorized Official Name | MR. GENNADIY ITSKIN (OWNER) |
| Authorized Official Telephone | 6178398299 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | MA | Nursing & Custodial Care Facilities |
| Street Address |
101 MYSTIC AVE |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-4628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992063820 | Gloria B. Donaii | Nursing Facility/Intermediate Care Facility | 60 Seymour Ln, Medford, NY 11763-1061 | 2012-04-29 |
| 1316267040 | Family Residences and Essential Enterprises | Nursing Facility/Intermediate Care Facility | 35 Hagerman Ave Apt 3, Medford, NY 11763-2145 | 2010-06-04 |
| 1457374332 | Servant Living Center - Medford LLC | Nursing Facility/Intermediate Care Facility | 616 S Front Street, Medford, OK 73759 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053873547 | Awenasa Home Inc. | Nursing Facility/Intermediate Care Facility | 71 Union St., Willowbrook Manor Rest Home, Millis, MA 02054 | 2019-04-03 |
| 1104242692 | Annelise Pfeiffer | Nursing Facility/Intermediate Care Facility | 1 Sleepy Hollow Dr, Plymouth, MA 02360-3579 | 2014-03-09 |
| 1780005330 | Registered Nurse Agency | Nursing Facility/Intermediate Care Facility | 580 Shawmut Ave, Apt 1a, Boston, MA 02118-1775 | 2013-12-30 |
| 1689939464 | Continuum Healthcare Solutions, LLC | Nursing Facility/Intermediate Care Facility | 52 Olney Rd, Palmer, MA 01069-9876 | 2012-07-09 |
| 1104017292 | Burgoyne Rest Home Inc | Nursing Facility/Intermediate Care Facility | 53 Hartford St, Dorchester, MA 02125-2829 | 2007-08-05 |
| 1043401136 | Anns Rest Home Inc. | Nursing Facility/Intermediate Care Facility | 66 Bowdoin Ave, Dorchester, MA 02121-3902 | 2007-08-05 |
| 1518169697 | Evelyn Rose Browning | Nursing Facility/Intermediate Care Facility | 84 Market St, Northampton, MA 01060-3210 | 2007-06-01 |
| 1972714509 | Eve Gibson | Nursing Facility/Intermediate Care Facility | 43 Truby St, Granby, MA 01033-9539 | 2007-05-25 |
| 1982815502 | Linda O'donnell | Nursing Facility/Intermediate Care Facility | 112 Pittroff Ave, South Hadley, MA 01075-2238 | 2007-05-25 |
| 1770799058 | Newfield House, Inc. | Nursing Facility/Intermediate Care Facility | 19 Newfield St, Plymouth, MA 02360-3401 | 2007-05-15 |
| Find all providers with the same taxonomy | ||||
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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.