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MERCY FAMILY PRACTICE PC NPI 1295717106


NPI Information

NPI: 1295717106
Provider Name: MERCY FAMILY PRACTICE PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 22D0068700

Address:
250 GREEN ST
SUITE 200
GARDNER, MA
ZIP 01440
Phone: (978) 632-6445
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MERCY FAMILY PRACTICE PC is a family medicine in Gardner, MA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERCY FAMILY PRACTICE PC NPI is 1295717106. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

250 GREEN ST
SUITE 200
GARDNER, MA
ZIP 01440-396
Phone: (978) 632-6445
Fax: (978) 630-3603

The provider's authorized official is Rebecca Worden .
The authorized official title is Cfo and has the following contact phone number (978) 632-6445.

The CLIA number assigned to this NPI record is 22D0068700 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/16/2005 and was last updated on 1/29/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1M21453MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
2110069347-AMEDICAIDMASSACHUSETTS
39732250MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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