Individual provider Active NPI

Howard Mudd, CRNA

  • Certified Registered Nurse Anesthetist
  • Berlin, NH
National Provider Identifier
1023054426
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
039337-23-11 Issued in NH
Practice address
59 Page Hill Rd
Anesthesia Department
Berlin, NH 03570-3531
Phone
(603) 752-3382
NPI assigned
Jun 22, 2006
Last updated
Sep 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 039337-21 NH
Certified Registered Nurse Anesthetist 367500000X 039337-23-11 NH Primary
Anesthesiology Physician 207L00000X 039337-23-11 NH

Addresses

Primary practice location

59 Page Hill Rd
Anesthesia Department
Berlin, NH 03570-3531

Mailing address

59 Page Hill Rd
Berlin, NH 03570-3531
Phone (603) 752-2200

Other identifiers 1

IdentifierTypeStateIssuer
30006944MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
039337-21NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Wood Anesthesia Services, P.C. Anesthesiology Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1023054426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 PAGE HILL RD",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703531",
            "telephone_number": "603-752-2200",
            "fax_number": "603-326-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PAGE HILL RD",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703531",
            "telephone_number": "603-752-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "HOWARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "039337-21",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "039337-23-11",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "039337-23-11",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006944",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.