Black Bear Medical NH Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

BLACK BEAR MEDICAL NH INC

Practice address

437 Portsmouth Ave Ste 4
Greenland, NH 03840-2244

Phone

(603) 547-9053

Fax

(603) 430-3745

NPI assigned

Nov 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg Crawford

Title

Authorized Official

Phone

(859) 441-8876

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1003095407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 TOWN DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410769114",
            "telephone_number": "859-350-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 PORTSMOUTH AVE STE 4",
            "city": "GREENLAND",
            "state": "NH",
            "postal_code": "038402244",
            "telephone_number": "603-547-9053",
            "fax_number": "603-430-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK BEAR MEDICAL NH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "859-441-8876"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30766045",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Behavioral Learning Network - New Hampshire LLC
• Robin W Bellantone, LCMHC
• Nicholas Bennett
• Melissa Berggren-Marshall, PH.D.
• Kenneth Paul Berthiaume, D.C.
• Bonnie Boisclair, LICSW
• Emily Bombard
• Adam Joash Bottrill, D.M.D
• Yonah Bottrill, ND
• Eve Lucia Boucouvalas, LMT

• Customized Equipment (DME) in Greenland, NH
• Providers in Greenland, NH by specialty
• Customized Equipment (DME) in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.