EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC (NPI# 1154600344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154600344 |
| Entity Type | Organization |
| Organization Name | EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | GREAT BROOK VALLEY HEALTH CENTER |
| Practice Address |
354 Waverly St Framingham MA 01702-7079 |
| Mailing Address |
650 Lincoln St Worcester MA 01605-2060 |
| Practice Telephone | 5083700113 |
| Practice Fax Number | 5083703637 |
| Mailing Telephone | 5088542122 |
| Mailing Fax Number | 5088538593 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2019-11-27 |
| Authorized Official Name | MR. STEPHEN J KERRIGAN (PRESIDENT/CEO) |
| Authorized Official Telephone | 5088542122 |
| Is Organization Subpart | Y |
| Parent Organization Name | EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110022061E | 05 |
| Other Name | Type Code |
|---|---|
| Great Brook Valley Health Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568828622 | Edward M. Kennedy Community Health Center, Inc | Registered Nurse | 354 Waverly St, Framingham, MA 01702-7079 | 2016-01-05 |
| 1316324650 | Edward M. Kennedy Community Health Center, Inc | Clinic/Center | 631 Lincoln St, Worcester, MA 01605-2010 | 2015-05-06 |
| 1992137426 | Edward M. Kennedy Community Health Center, Inc | Clinic/Center | 42 Cape Rd, Milford, MA 01757-3292 | 2013-08-07 |
| 1700152758 | Edward M. Kennedy Community Health Center, Inc | Clinic/Center | 585 Lincoln St, Worcester, MA 01605-1906 | 2012-03-23 |
| 1497984363 | Edward M. Kennedy Community Health Center, Inc | Clinic/Center | 72 Union Ave, Framingham, MA 01702-8216 | 2009-07-13 |
| 1013048347 | Edward M. Kennedy Community Health Center, Inc | Pharmacy | 19 Tacoma St, Worcester, MA 01605-3516 | 2007-03-08 |
| 1609842152 | Edward M. Kennedy Community Health Center, Inc | Clinic/Center | 19 Tacoma St, Worcester, MA 01605-3516 | 2006-02-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC. | 650 Lincoln St Ste 1, Worcester, MA 01605-2060 |
| Street Address |
354 WAVERLY ST |
| City | FRAMINGHAM |
| State | MA |
| Zip Code | 01702-7079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902865967 | Margaret E Gentile | Nurse Practitioner | 354 Waverly St, Framingham, MA 01702-7079 | 2006-03-20 |
| 1386245835 | Helen V Tsiagras | Registered Nurse | 354 Waverly St, Framingham, MA 01702-7079 | 2020-11-02 |
| 1336799261 | Sara Doyle | Counselor | 354 Waverly St, Framingham, MA 01702-7079 | 2019-09-12 |
| 1265926141 | Mina Alexandra Kelley | Behavior Technician | 354 Waverly St, Framingham, MA 01702 | 2018-06-14 |
| 1629590237 | Paige Cunningham | Counselor | 354 Waverly St, Framingham, MA 01702 | 2017-07-14 |
| 1124557459 | Nathaniel David Joslin | Counselor | 354 Waverly St, Framingham, MA 01701 | 2017-06-09 |
| 1215465299 | Adrianna Deborah Rosadio | Counselor | 354 Waverly St, Framingham, MA 01702 | 2017-06-02 |
| 1073047783 | Audrey Davis | Social Worker | 354 Waverly St, Framingham, MA 01702-7079 | 2017-04-19 |
| 1689118838 | Jessica Bylund | Counselor | 354 Waverly St, Framingham, MA 01702 | 2016-12-07 |
| 1437693710 | Patti Sheinman | Social Worker | 354 Waverly St, Framingham, MA 01702-7079 | 2016-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720635295 | Astrid Bautista | Counselor | 345 Waverly Street, Framingham, MA 01702 | 2019-08-20 |
| 1598223588 | Roshini Mary Mathew | Counselor | 298 Howard Street Suite 100, Framingham, MA 01702 | 2019-03-08 |
| 1114401411 | Raquel Suzanne Martha Woodard | Social Worker | 475 Franklin St Suite 101 Adoption Choices, Framingham, MA 01702 | 2018-09-21 |
| 1457840720 | Randine Elizabeth Parry | Psychologist | 15 Cherry Oca Ln, Framingham, MA 01702 | 2018-05-02 |
| 1043707664 | Amanda Coughlin | Social Worker | 475 Franklin St Ste 101, Framingham, MA 01702 | 2018-04-19 |
| 1649799438 | Davis Square Dental Specialists LLC | Dentist | 509 Concord Street, Framingham, MA 01702 | 2017-09-13 |
| 1801315775 | Zahra Majidi | Developmental Therapist | Criterion, 651 Franklin St., Framimgham, MA 01702 | 2017-09-12 |
| 1356893119 | Angelic Love Home Care | Home Health | 47 Melen St, Framingham, MA 01702 | 2016-10-27 |
| 1598116634 | Katherine Mcclean | Nutritionist | 19 Linden St Apt D, Framingham, MA 01702 | 2016-06-30 |
| 1205282548 | Rafaela Dos Santos | Nurse Practitioner | 354 Waverly St., Framingham, MA 01702 | 2016-05-05 |
| Find all providers in zip 01702 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780183913 | Family Health Center of Worcester, Inc. | Clinic/Center | 420 Grafton St, Worcester, MA 01604-3802 | 2018-02-02 |
| 1942759162 | Community Health Programs, Inc | Clinic/Center | 510 North St., Pittsfield, MA 01201 | 2016-09-29 |
| 1942663851 | Boston Health Care for The Homeless Program, Inc. | Clinic/Center | 461 Walnut Ave, Jamaica Plain, MA 02130 | 2016-03-30 |
| 1497148407 | Brockton Neighborhood Health Center | Clinic/Center | 158 Pleasant Street, Brockton, MA 02301 | 2015-03-16 |
| 1053729426 | Community Health Connections, Inc. | Clinic/Center | 140 Arnhow Farm Road, Fitchburg, MA 01420-1369 | 2014-07-29 |
| 1689092595 | Lowell Community Health Center, Inc. | Clinic/Center | 101 Jackson St, Lowell, MA 01852-2103 | 2014-03-29 |
| 1912272899 | Community Health Programs, Inc | Clinic/Center | 19 Depot Street, Adams, MA 01220 | 2012-03-12 |
| 1225323777 | Family Health Center of Worcester, Inc. | Clinic/Center | 14 Richards St, Goddard Health Center, Worcester, MA 01603-2609 | 2011-06-13 |
| 1801181334 | Family Health Center of Worcester, Inc. | Clinic/Center | 140 Apricot St, Sullivan Middle Health Center, Worcester, MA 01603-1225 | 2011-06-13 |
| 1720373251 | Family Health Center of Worcester, Inc. | Clinic/Center | 299 Highland St, Doherty School Based Health Center, Worcester, MA 01602-2110 | 2011-06-13 |
| Find all providers with the same taxonomy | ||||
| City | FRAMINGHAM |
| Zip Code | 01702 |
Please comment or provide details below to improve the information on EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC.
| 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.