1467366492 NPI number — FELLS COMMUNITY HEALTH PARTNERS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467366492 NPI number — FELLS COMMUNITY HEALTH PARTNERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FELLS COMMUNITY HEALTH PARTNERS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467366492
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 HIGH ST STE 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02155-3848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-690-7722
Provider Business Mailing Address Fax Number:
857-491-8743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 HIGH ST STE 10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02155-3848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-690-7722
Provider Business Practice Location Address Fax Number:
857-491-8743
Provider Enumeration Date:
09/29/2026

Additional Information

Authorized Official

Authorized Official Last Name:
NARO
Authorized Official First Name:
RAEDJIO
Authorized Official Middle Name:
KAY ARROWROOT
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
617-690-7722

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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