NPIMap

Organization Active NPI

Wakefield Family Medicine LLC

  • Family Medicine Physician
  • Sanbornville, NH
National Provider Identifier
1053424440
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8928 Issued in NH
Legal business name
WAKEFIELD FAMILY MEDICINE LLC
Practice address
131 Meadow St
Sanbornville, NH 03872-4329
Phone
(603) 871-8227
Fax
(603) 871-8285
NPI assigned
Aug 17, 2006
Last updated
Dec 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Dennis S Badman, MDNPI 1508847120
Title
Owner
Phone
(603) 871-8227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8928 NH Primary

Addresses

Primary practice location

131 Meadow St
Sanbornville, NH 03872-4329

Mailing address

131 Meadow St
Sanbornville, NH 03872-4329
Phone (603) 871-8227

Other identifiers 3

IdentifierTypeStateIssuer
133380OtherCIGNA
30007719MedicaidNH
01090954PNH01OtherANTHEM

National Provider Directory

National Provider Directory

Locations

131 Meadow St
Sanbornville, NH 03872
Phone (603) 522-5010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1053424440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MEADOW ST",
            "city": "SANBORNVILLE",
            "state": "NH",
            "postal_code": "038724329",
            "telephone_number": "603-871-8227",
            "fax_number": "603-871-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MEADOW ST",
            "city": "SANBORNVILLE",
            "state": "NH",
            "postal_code": "038724329",
            "telephone_number": "603-871-8227",
            "fax_number": "603-871-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFIELD FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "BADMAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-871-8227",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "8928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "133380",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007719",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "01090954PNH01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanbornville, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.