Individual provider Active NPI

Bethany Louise Dewkett, APRN

  • Critical Care Neonatal Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1063243210
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
058103-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-7256
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 058103-21 NH
Neonatal Nurse Practitioner 363LN0000X 058103-23 NH
Critical Care Neonatal Nurse Practitioner 363LN0005X 058103-23 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

114 Chalk Pond Rd
Newbury, NH 03255-6014
Phone (603) 731-5438

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030002185 NH Practitioner - Nurse Practitioner 3072046929 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058103-21NHMDNeonatal Intensive Care Registered Nurse
058103-23NHMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 28, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 28, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 28, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 28, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1063243210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CHALK POND RD",
            "city": "NEWBURY",
            "state": "NH",
            "postal_code": "032556014",
            "telephone_number": "603-731-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWKETT",
        "first_name": "BETHANY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NH",
            "license": "058103-21",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NH",
            "license": "058103-23",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NH",
            "license": "058103-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.