Active NPI
Heather Wilde
- Behavior Technician
- North Conway, NH
National Provider Identifier
1073230686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 170 Kearsarge Rd
North Conway, NH 03860-5331 - Phone
- (603) 356-6616
- NPI assigned
- Oct 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
170 Kearsarge Rd
North Conway, NH 03860-5331
Mailing address
PO Box 605
Center Conway, NH 03813-0605
Phone (603) 413-1070
Other names 1
- Heather Fougere
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1073230686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 605",
"city": "CENTER CONWAY",
"state": "NH",
"postal_code": "038130605",
"telephone_number": "603-413-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 KEARSARGE RD",
"city": "NORTH CONWAY",
"state": "NH",
"postal_code": "038605331",
"telephone_number": "603-356-6616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDE",
"first_name": "HEATHER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "FOUGERE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Conway, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.