Individual provider Active NPI

Gerard Robert Beaudry, MSN, ACNP

  • Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1104253434
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
063188-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 308-1467
NPI assigned
Oct 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 063188-23 NH
Acute Care Nurse Practitioner 363LA2100X 101.0118274 VT
Nurse Practitioner 363L00000X 063188-23 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 308-1467

Other practice location 1

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131206000865 NH Practitioner - Nurse Practitioner 3173501004 Reassigns benefits to 2 organizations
I20160602000572 VT Practitioner - Nurse Practitioner 3173501004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Hospital & facility affiliations

  • Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
101.0118274VTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Vermont Pathology PC Current Accepting new patients
Springfield Hospital .Inc CurrentSince Apr 1, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 17, 2022 Accepting new patients
Rutland Hospital, Inc Current Accepting new patients
Rutland Hospital, Inc. Current Accepting new patients
Rutland Hospital, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 28, 2013 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 17, 2022 Accepting new patients
Rutland Hospital, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Rutland Hospital, Inc. Current Accepting new patients
Springfield Hospital CurrentSince Apr 1, 2016 Accepting new patients

Locations

250 Ceda Rd
Charlestown, NH 03603
Phone (603) 826-5711

243 Elm St
Claremont, NH 03743
Phone (603) 542-7771

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

160 Allen St
Rutland, VT 05701

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/
  • Direct secure messaging: vrhgbeaud@yourcarecommunity.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1104253434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-308-1467"
        },
        {
            "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": "037561000",
            "telephone_number": "603-308-1467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Allen St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014560",
            "country_code": "US",
            "telephone_number": "802-775-7111",
            "fax_number": "802-747-6207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "GERARD",
        "middle_name": "ROBERT",
        "credential": "MSN, ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NH",
            "license": "063188-23",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VT",
            "license": "101.0118274",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "063188-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.