Jeanne M Herrmann, PA-C
Individual provider Active NPI Physician Assistant · Concord, NH
NPI 1124058300 · NPPES record last updated Jan 29, 2024
Key facts
- NPI
- 1124058300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0382 (NH)
- Practice address
- 264 Pleasant St
Concord, NH 03301-2551 - Phone
- (603) 224-3368
- Fax
- (603) 724-2581
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050318000819 | NH | Practitioner - Physician Assistant | 7416902770 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0382 | NH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Orthopaedic Alliance PLLC | Current |
Accepting new patients | |
| Concord Orthopaedics Professional Association | Current |
Accepting new patients | |
| Concord Orthopaedics Professional Association | Current |
Accepting new patients |
Locations
264 Pleasant St
Concord, NH 03301
6 Tsienneto Rd
Ste 200
Derry, NH 03038
Phone (603) 426-5222
103 Boulder Point Dr
Plymouth, NH 03264
Phone (603) 536-1284
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0382 | NH | Yes |
Addresses
Primary practice location
264 Pleasant St
Concord, NH 03301-2551
Mailing address
264 Pleasant St
Concord, NH 03301-2551
Phone (603) 224-3368
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30331166 | Medicaid | NH |
Other providers in Concord, NH
- Heritage Case Management
- Emilio Roberto Hernandez
- Lauren Mae Herold
- Allison L Herrick
- Pamela J Herring
- Andrew Hershey
- Kristine Hewitt
- Keegan Hickey
- Paige Elizabeth Hickey
- Patricia Rogers Hicks
All providers in Concord, NH · Physician Assistant in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.