SOUTHCOAST PHYSICIANS GROUP, INC. (NPI# 1700393808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700393808 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST PHYSICIANS GROUP, INC. |
| Other Organization Name | SOUTHCOAST URGENT CARE CENTER - LAKEVILLE |
| Practice Address |
12 Main St Lakeville MA 02347-1606 |
| Mailing Address |
200 Mill Rd Ste 180 Fairhaven MA 02719-5255 |
| Practice Telephone | 5089732432 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | KIMBERLEY COON (DIRECTOR, MEDICAL STAFF SVCS) |
| Authorized Official Telephone | 5089732432 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MA | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | MA | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | MA | Allopathic & Osteopathic Physicians | |
| N | 208M00000X | Hospitalist | MA | Allopathic & Osteopathic Physicians | |
| Y | 207P00000X | Emergency Medicine | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110072422A | 05 | |
| MA | MEDICARE | M20518 | 01 |
| RI | MEDICARE | 709004034 | 01 |
| MA | RAILROAD MEDICARE | CD2506 | 01 |
| RI | MEDICAID - RI | BM20689 | 01 |
| Other Name | Type Code |
|---|---|
| Southcoast Urgent Care Center - Lakeville | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841787652 | Southcoast Physicians Group, Inc. | Family Medicine | 670 Aquidneck Avenue, Middletown, RI 02841 | 2018-04-17 |
| 1770090870 | Southcoast Physicians Group, Inc. | Family Medicine | 636 County St, Taunton, MA 02780-3604 | 2018-01-10 |
| 1235646332 | Southcoast Physicians Group, Inc. | Family Medicine | 374 William S Canning Blvd, Fall River, MA 02721-2352 | 2018-01-10 |
| 1134664253 | Southcoast Physicians Group, Inc. | Family Medicine | 435 State Rd, Unit F, North Dartmouth, MA 02747-4306 | 2016-12-28 |
| 1306381421 | Southcoast Physicians Group, Inc. | Family Medicine | 37 Commerce Way, Seekonk, MA 02771-5816 | 2016-12-28 |
| 1336137629 | Southcoast Physicians Group, Inc. | Internal Medicine | 200 Mill Road, Suite 180, Fairhaven, MA 02719-5252 | 2005-10-11 |
| 1750869681 | Southcoast Physicians Group, Inc. | Audiologist | 200 Mill Rd Ste 180, Fairhaven, MA 02719-5255 | 2018-08-02 |
| 1619413150 | Southcoast Physicians Group, Inc. | Family Medicine | 2421 Cranberry Hwy, Wareham, MA 02571-5021 | 2017-01-09 |
| 1346634052 | Southcoast Physicians Group, Inc. | Internal Medicine | 1030 President Ave, Suite 110, Fall River, MA 02720-5923 | 2015-03-20 |
| 1225421118 | Southcoast Physicians Group, Inc. | Physical Therapist | 479 Swansea Mall Dr, Swansea, MA 02777-4119 | 2015-03-17 |
| Street Address |
12 MAIN ST |
| City | LAKEVILLE |
| State | MA |
| Zip Code | 02347-1606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952382012 | Sharon L Marable | Internal Medicine | 12 Main St, Lakeville, MA 02347-1606 | 2005-11-07 |
| 1578824769 | Lauren Colello Hoogewerff | Family Medicine | 12 Main St, Lakeville, MA 02347-1606 | 2012-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902424302 | Sherry Ann Szczepkowski-demoura | Nurse Practitioner | 82 Freetown Street, Lakeville, MA 02347 | 2020-07-12 |
| 1730678038 | Wagner Pt & Performance LLC | Clinic/Center | 290 Bedford St, Lakeville, MA 02347 | 2018-05-02 |
| 1275960478 | Scott Michael Jarvis | Social Worker | 5 Bells Brook Rd, Lakeville, MA 02347 | 2013-10-02 |
| 1508034240 | Nelia M. Rodelle | Technician/Technologist | 47 Fuller Shores Road, Lakeville, MA 02347 | 2008-02-15 |
| 1497951594 | Lakeville Physical Therapy Inc | Physical Therapist | 155 Millennium Cir, Suite 114, Lakeville, MA 02347 | 2007-06-25 |
| 1609901875 | Lift & Care Systems, Inc. | Durable Medical Equipment & Medical Supplies | 7 Precinct Street, Lakeville, MA 02347 | 2007-02-21 |
| 1154479582 | Stephen Givinal Gouveia | Physical Therapist | 155 Millenium Dr, Lakeville Physical Therapy Inc Suite 114, Lakeville, MA 02347 | 2007-01-08 |
| 1992802615 | George Palaiologos | Chiropractor | 66 Main Street, Lakeville, MA 02347 | 2006-09-17 |
| 1326055419 | Cameron Luree Marzelli | Psychologist | 104 Charles Eldredge Drive, Lakeville, MA 02347 | 2006-08-02 |
| 1740295617 | Paige A Leavitt-halsall | Registered Nurse | 104 Charles Eldridge Drive, Tranquil Mind & Wellness Inc, Lakeville, MA 02347 | 2006-07-29 |
| Find all providers in zip 02347 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
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| 1639367725 | Fitzgerald Anthony Hudson | Emergency Medicine | 5989 Big Tree Rd, Lakeville, NY 14480-9719 | 2007-10-15 |
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| 1518523810 | Center for Vein Restoration Ma LLC | Emergency Medicine | 3640 Main St Ste 302, Springfield, MA 01107-1134 | 2019-05-13 |
| 1629555842 | Dispatchhealth Massachusetts PC | Emergency Medicine | 123 Park Ave, West Springfield, MA 01089-3337 | 2018-07-20 |
| 1366947954 | Karrin Weisenthal | Emergency Medicine | 1 Boston Pl Rm 1322, Boston, MA 02108 | 2018-03-27 |
| 1942705884 | Jillian Britt Duffy | Emergency Medicine | 1 Boston Medical Ctr Pl Rm 1322, Boston, MA 02118 | 2018-03-23 |
| 1316464621 | Katelyn Anne Brightman | Emergency Medicine | 30 Florence St, Somerville, MA 02145-4307 | 2017-08-28 |
| 1245760024 | Nicholas D. Kurtzman | Emergency Medicine | One Deaconess Road Rosenberg Building, 2nd Floor, Department of Emergency Medicine, Boston, MA 02215 | 2017-06-14 |
| 1821528746 | Daniel Lapidus | Emergency Medicine | 1963 Commonwealth Ave, Brighton, MA 02135-5937 | 2017-06-13 |
| 1942730007 | Alec John Koffer | Emergency Medicine | 1 Deaconess Rd Bldg 2nd, Boston, MA 02215-5321 | 2017-06-12 |
| 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.