Danette T Colella

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19572 Issued in NH

Practice address

101 Boulder Point Dr Ste 1
Plymouth, NH 03264-3170

Phone

(603) 536-4000

Fax

(603) 536-4000

NPI assigned

Oct 21, 2005

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 17

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mid-State Health Center

  • Internal Medicine Physician
  • Plymouth, NH
  • NPI 1811156409
  Medicare reassignment NPD
• Greater Seacoast Community Health

  dba Goodwin Community Health

  • Federally Qualified Health Center (FQHC)
  • Somersworth, NH
  • NPI 1578854287
  NPD
• Mid-State Health Center

  • Infusion Therapy Clinic/Center
  • Plymouth, NH
  • NPI 1609354208
  NPD
• Mid-State Health Center

  • Family Medicine Physician
  • Plymouth, NH
  • NPI 1932920857
  NPD
• Lake Country Pediatrics SC

  dba Lake Country Physicians

  • Pediatrics Physician
  • Oconomowoc, WI
  • NPI 1801849963
  NPD (past)

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1033109095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR STE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643170",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR STE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643170",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2574 Sun Valley Dr Ste 207",
            "address_purpose": "LOCATION",
            "city": "Delafield",
            "state": "WI",
            "postal_code": "530182334",
            "country_code": "US",
            "telephone_number": "262-646-2282",
            "fax_number": "262-646-7535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 Route 108",
            "address_purpose": "LOCATION",
            "city": "Somersworth",
            "state": "NH",
            "postal_code": "038781522",
            "country_code": "US",
            "telephone_number": "603-749-2346",
            "fax_number": "603-953-0066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLELLA",
        "first_name": "DANETTE",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "159758",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "64573",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "19572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HLTH PLAN",
            "identifier": "0016422",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCVM",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "159758",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "42310",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7457583",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOC FIRST",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J19947",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3118251",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3191664",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST HEALTH CARE",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100051863",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GIC UNICARE",
            "identifier": "042297845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HVD PILGRIM HEALTH CARE",
            "identifier": "710585",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B10361201",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jean Clougherty, OTA
• Alyssa Cohen
• Lindsay Michelle Colley, PT, MSPT
• Natalie Martha Compton, OTR/L
• Molly Elizabeth Comrie, MSW
• Leesa A Conway, MSPT
• Barbara Coonan

• Pediatrics Physician in Plymouth, NH
• Providers in Plymouth, NH by specialty
• Pediatrics Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.