Active NPI
Alex Reardon
- Psychiatric/Mental Health Nurse Practitioner
- Derry, NH
National Provider Identifier
1023675824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 069995-23
- Practice address
- 10 Tsienneto Rd
Derry, NH 03038-1505 - Phone
- (603) 434-1577
- Fax
- (603) 434-3101
- NPI assigned
- May 28, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 069995-23 | NH | Primary |
Addresses
Primary practice location
10 Tsienneto Rd
Derry, NH 03038-1505
Mailing address
10 Tsienneto Rd
Derry, NH 03038-1505
Phone (603) 434-1577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10 Tsienneto Rd
Derry, NH 03038-1505
Phone (603) 434-1577
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Derry, NH
- NPI 1003914466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1023675824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 TSIENNETO RD",
"city": "DERRY",
"state": "NH",
"postal_code": "030381505",
"telephone_number": "603-434-1577",
"fax_number": "603-434-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 TSIENNETO RD",
"city": "DERRY",
"state": "NH",
"postal_code": "030381505",
"telephone_number": "603-434-1577",
"fax_number": "603-434-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "ALEX",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-28",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NH",
"license": "069995-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derry, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.