1952579674 NPI number — DR. STEPHEN L. SIMPSON, M.D., P.C.

Table of content: (NPI 1952579674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952579674 NPI number — DR. STEPHEN L. SIMPSON, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. STEPHEN L. SIMPSON, M.D., P.C.
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:
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:
1952579674
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02940-6300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-862-0025
Provider Business Mailing Address Fax Number:
978-862-0049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
198 GROTON RD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
AYER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01432-1177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-862-0025
Provider Business Practice Location Address Fax Number:
978-862-0049
Provider Enumeration Date:
02/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FLANNERY
Authorized Official First Name:
SARA
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
978-862-0025

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  205051 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 103355800 . This is a "ACS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J22501 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101877 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6919759006 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 408251 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 48317 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2430200 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0900631 . This is a "UNITED HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 172414 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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