Alice Peck Day Memorial Hospital

Organization Active NPI Family Medicine Physician · Lebanon, NH

NPI 1073569810 · NPPES record last updated Apr 25, 2013

Key facts

NPI
1073569810
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
00016 (NH)
Legal business name
ALICE PECK DAY MEMORIAL HOSPITAL
Practice address
10 Alice Peck Day Dr
Lebanon, NH 03766-2647
Phone
(603) 448-3122
Fax
(603) 448-7491
NPI assigned
May 25, 2006
Organization subpart
Yes
Parent organization (as reported)
ALICE PECK DAY MEMORIAL HOSPITAL

Authorized official

Name
Susan E Mooney, MD
Title
Ceo/President
Phone
(603) 448-3121

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 306

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 306

Affiliated clinicians 530

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 530

Medicare Care Compare: Hospital

Listed as
Alice Peck Day Memorial Hospital CCN 301305
Overall star rating
★★★★☆ 4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NH

Hospital certification: CCN 301305

Legal name
ALICE PECK DAY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2003
Last certification
Jan 20, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
10 Alice Peck Day Dr
Lebanon, NH 37662900
Main/Primary Hospital Location

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christopher L Hubble
Individual
Corporate Director
Board of Trustee
Jan 1, 2024
Gerard I Duprat
Individual
Corporate Director
Board of Directors
Jan 1, 2022
Anna Adachi-Mejia
Individual
Corporate Director
Board of Directors
Jan 1, 2023
Jenny Barba
Individual
Corporate Director
Board of Directors
Jan 1, 2022
Jennifer S Schiffman
Individual
Corporate Director
Board of Directors
Jan 1, 2017
Clayton R Adams
Individual
Corporate Director
Board of Directors
Jan 1, 2018
David Duncan
Individual
Corporate Director
Board of Trustee
Jan 1, 2022
Charles J Wheelan
Individual
Corporate Director
Board of Directors
Jan 1, 2018
Marisa D Devlin
Individual
Corporate Director
Board of Directors
Jan 1, 2018
Laura M Greer
Individual
Corporate Director
Board of Directors
Jan 1, 2023
Scott W Rodi
Individual
Corporate Director
Board of Directors
Jan 1, 2019
Michael T Lynch
Individual
Corporate Officer
Ceo
Oct 13, 2025 2%
W-2 Managing Employee Oct 13, 2025
Patrick F Jordan
Individual
Corporate Director
Board of Trustee
Jan 1, 2019
Dartmouth-Hitchcock Health
Organization · Lebanon, NH
Corporation
Operational/Managerial Control Mar 1, 2016 100%
Laura Gillespie
Individual
Corporate Director
Board of Directors
Jan 1, 2024
H. Sloane Mayor
Individual
Corporate Director
Board of Directors
Jan 1, 2022
Tegan Deogburn
Individual
Corporate Director
Director - Mso
Dec 6, 2023
Patrici Drew
Individual
Operational/Managerial Control
Manager, Enrollment Ops
Sep 1, 2025
Michele Perkins
Individual
Corporate Director
Board of Directors
Jan 1, 2025
Cybele M Merrick
Individual
Corporate Director
Board of Directors
Jan 1, 2021
Barbara Moore
Individual
Corporate Director
Director of Ar Management
Apr 1, 2020
Susan E Mooney
Individual
Corporate Officer
Ceo
Oct 1, 2012
W-2 Managing Employee Oct 1, 2012
Courtney Tanner
Individual
Corporate Director
Board of Trustee
Jan 1, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040927000296 NH Part B Supplier - Clinic/Group Practice 6103737531 Receives reassigned benefits from 335 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, NH
O20061104000184 NH Part a Provider - Critical Access Hospital 6103737531 Receives reassigned benefits from 302 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, NH

National Provider Directory

Part of
Alice Peck Day Hosp Iap

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 00016 NH Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X 00016 NH
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X 00016 NH
Occupational Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2083X0100X
Occupational Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2083X0100X 00016 NH
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208VP0000X

Addresses

Primary practice location

10 Alice Peck Day Dr
Lebanon, NH 03766-2647

Mailing address

10 Alice Peck Day Dr
Lebanon, NH 03766-2647
Phone (603) 448-3122

Other names

  • Physician Practices at Alice Peck Day Doing business as

Other providers in Lebanon, NH

All providers in Lebanon, NH · Family Medicine Physician in New Hampshire

Sources for this page

Verify at the official NPI Registry.