Speare Memorial Hospital
Organization Active NPI Specialist · Plymouth, NH
NPI 1023036191 · NPPES record last updated Apr 11, 2018
Key facts
- NPI
- 1023036191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- SPEARE MEMORIAL HOSPITAL
- Practice address
- 16 Hospital Rd
Plymouth, NH 03264-1126 - Phone
- (603) 536-1120
- NPI assigned
- Jul 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Michelle L McEwen
- Title
- President/Ceo
- Phone
- (603) 536-1120
Owners & managing parties with NPI records 2
-
Joseph A Ebner, MD
Other NPIs on the same Medicare enrollment 3
Member organizations 2
Related certifications (CCN) 4
Practitioners 1
Affiliated clinicians 219
-
Munder Abuaisha, MD
-
Karen M Armento, CRNA
-
Joseph K. Azar, MD
-
Jessica Mackenzie Baker, PA-C
-
Lisa B Baker, PA-C
-
Kyle T Baron, MD
-
Yaroslav Basyuk, MD
-
Reda Benhorma, MD
-
Tomasz Blaszczak, MD
-
Adam M Boise, APRN
-
Eric M Bonnem, MD
-
Victoria Marie Booth, APRN
-
Karen J Boselli, MD
Medicare Care Compare: Hospital
- Listed as
- Speare Memorial Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Hospital certification: CCN 301311
- Legal name
- SPEARE MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- May 5, 2005
- Last certification
- Sep 23, 2021
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 16 Hospital Rd
Plymouth, NH 32641126
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Elizabeth Kleiner |
Corporate Director |
Oct 12, 2016 | |
| Susan Scrimshaw |
Corporate Director | Oct 21, 2021 | |
| John Moulton |
Corporate Director |
Nov 1, 2024 | |
| Joseph T Caristi |
Corporate Officer |
Feb 19, 2024 | |
| Corporate Director |
Feb 19, 2024 | ||
| W-2 Managing Employee |
Feb 19, 2024 | ||
| Operational/Managerial Control |
Feb 19, 2024 | ||
| Margaret Turner |
Corporate Director |
Sep 18, 2014 | |
| Patrick B Miller |
Corporate Director |
Sep 18, 2014 | |
| Joseph a Ebner |
Corporate Director | Jan 1, 2008 | |
| Craig Williams |
Corporate Officer |
Jun 1, 2026 | |
| Corporate Director |
Jun 1, 2026 | ||
| W-2 Managing Employee |
Jun 1, 2026 | ||
| Kevin I Young |
Corporate Director |
Sep 18, 2014 | |
| Walter Johnson |
Corporate Director | Oct 25, 2018 | |
| Steven Camerino |
Corporate Director | Oct 23, 2019 | |
| Donna Driscoll |
Corporate Director |
Nov 1, 2024 | |
| Ken Evans |
Corporate Director |
Nov 1, 2024 | |
| Julie Bernier |
Corporate Director | Oct 25, 2018 | |
| Eric M Shamansky |
Corporate Director |
Sep 11, 2023 | |
| Dolores C Hopper |
Corporate Director | Oct 27, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070220000493 | NH | Part a Provider - Critical Access Hospital | 1153318068 |
Receives reassigned benefits from 64 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Plymouth, NH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
16 Hospital Rd
Plymouth, NH 03264-1126
Mailing address
16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 238-2204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30212660 | Medicaid | NH | |
| 3076998 | Medicaid | NH |
Other providers in Plymouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.