Kendal at Hanover I

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

01775 Issued in NH

Legal business name

KENDAL AT HANOVER I

Practice address

80 Lyme Road
Hanover, NH 03755

Phone

(603) 643-8900

Fax

(603) 643-7099

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Brent B Edgerton

Title

Associate Executive Director

Phone

(603) 643-7004

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1083756399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 LYME ROAD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "03755",
            "telephone_number": "603-643-8900",
            "fax_number": "603-643-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 LYME ROAD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "03755",
            "telephone_number": "603-643-8900",
            "fax_number": "603-643-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDAL AT HANOVER I",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "EDGERTON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ASSOCIATE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "603-643-7004"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NH",
            "license": "01954",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NH",
            "license": "01775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen E Kebalka
• Samantha Keller
• Jill M Kelly-Ketay
• Elizabeth Kelsey
• Ann Kemon, RDH
• Kendal at Hanover I
• Grace Prosperi Ketcham, PSYD
• Yusuf Ali Khan, MD
• Nancy Hayes Kilgore, D.MIN.
• Knight Pharmacy Inc

• Skilled Nursing Facility in Hanover, NH
• Providers in Hanover, NH by specialty
• Skilled Nursing Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.