NPIMap

Organization Active NPI

Speare Memorial Hospital

  • Ophthalmology Physician
  • Plymouth, NH
National Provider Identifier
1104153535
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SPEARE MEMORIAL HOSPITAL
Practice address
103 Boulder Point Drive
Plymouth, NH 03264-3168
Phone
(603) 536-1284
Fax
(603) 536-3136
NPI assigned
Nov 5, 2009
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SPEARE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Michelle L McEwen
Title
President/Ceo
Phone
(603) 536-1120

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

103 Boulder Point Drive
Plymouth, NH 03264-3168

Mailing address

16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 238-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100226000358 NH Part B Supplier - Clinic/Group Practice 1153318068 Receives reassigned benefits from 2 practitioners
Practice locations: Plymouth, NH

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Weight Management Wellness10 organizations share this tax ID, including this one
Part of
Weight Management Wellness

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1104153535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL RD",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032641126",
            "telephone_number": "603-238-2204",
            "fax_number": "603-536-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BOULDER POINT DRIVE",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643168",
            "telephone_number": "603-536-1284",
            "fax_number": "603-536-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARE MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPEARE MEMORIAL HOSPITAL",
        "enumeration_date": "2009-11-05",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "603-536-1120"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.