Healthcare Provider Details

I. General information

NPI: 1659153203
Provider Name (Legal Business Name): URGENT CARE MEDICAL ASSOCIATES OF MASSACHUSETTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BELMONT ST
BROCKTON MA
02301-4404
US

IV. Provider business mailing address

PO BOX 1339
GLASTONBURY CT
06033-6339
US

V. Phone/Fax

Practice location:
  • Phone: 860-650-3848
  • Fax:
Mailing address:
  • Phone: 860-430-1246
  • Fax: 860-656-0669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEANNIE M KENKARE
Title or Position: PRESIDENT
Credential: DO
Phone: 203-616-4440