NPIMap

Organization Active NPI

Appledore Medical Group-Diabetes Resource Center

  • Registered Dietitian
  • Portsmouth, NH
National Provider Identifier
1013227594
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
314 Issued in NH
Legal business name
APPLEDORE MEDICAL GROUP-DIABETES RESOURCE CENTER
Practice address
155 Borthwick Ave
Portsmouth, NH 03801-7156
Phone
(603) 433-5160
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Authorized official

Name
Tedrick Johnson
Title
VP, HCA Physician Services
Phone
(807) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 314 NH Primary

Addresses

Primary practice location

155 Borthwick Ave
Portsmouth, NH 03801-7156

Mailing address

155 Borthwick Ave
Portsmouth, NH 03801-7156
Phone (603) 433-5160

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D0999732Appledore Medical Group155 Borthwick Ave Suite 202, Portsmouth, NH 03801Certificate of waiverJul 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Appledore Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1013227594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017156",
            "telephone_number": "603-433-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017156",
            "telephone_number": "603-433-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEDORE MEDICAL GROUP-DIABETES RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TEDRICK",
        "authorized_official_title_or_position": "VP, HCA PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "807-237-7760"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.