Northeast Surgical Care of Newington, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

02754 Issued in NH

Legal business name

NORTHEAST SURGICAL CARE OF NEWINGTON, LLC

Practice address

2299 Woodbury Avenue
Suite 5
Newington, NH 03801-7854

Phone

(603) 431-5563

Fax

(603) 431-2544

NPI assigned

Jun 17, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northeast Surgical Care Doing business as

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1043215858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "615-665-1283",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 WOODBURY AVENUE",
            "address_2": "SUITE 5",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038017854",
            "telephone_number": "603-431-5563",
            "fax_number": "603-431-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SURGICAL CARE OF NEWINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NH",
            "license": "02754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30622341",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Surgical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Travis Palmer, FNP-C
• Andrea Martin Parsons, M.ED., LCMHC
• Laura M. Peterson, LICSW
• Patricia Ann Pettis, APRN

• Ambulatory Surgical Clinic/Center in Newington, NH
• Providers in Newington, NH by specialty
• Ambulatory Surgical Clinic/Center in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.