CMC D/B/a Urgent Care at Bedford Medical Park
Organization Active NPI Urgent Care Clinic/Center · Bedford, NH
NPI 1134410319 · NPPES record last updated Aug 9, 2022
Key facts
- NPI
- 1134410319
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- CMC D/B/A URGENT CARE AT BEDFORD MEDICAL PARK
- Practice address
- 5 Washington Place
Bedford, NH 03110 - Phone
- (603) 314-4567
- NPI assigned
- Apr 22, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- CATHOLIC MEDICAL CENTER
Authorized official
- Name
- Edward Dudley
- Title
- Evp/Cfo
- Phone
- (603) 663-6180
Other NPIs on the same Medicare enrollment 1
Practitioners 38
-
Brian E Claussen, M.D.
-
Todd David Daugherty, M.D.
-
Judith A Devine, M.D.
-
Caitlin Marie Duggar, APRN
-
Jessica Lynn Dumais, ARNP
-
Ashlynn Fogg, APRN
-
Catherine Fogg, APRN, PHD
-
Kate Ann Gagnon, PA-C
-
Justin Jeffrey Godin, APRN
-
Vonda Haas-Rueda, PA
-
Samantha J Harrington, PA-C
-
Ivan K Ip, M.D., MPH
-
Emilianos N Karagiannis, M.D.
-
Matthew K Libman, D.O.
-
Jill S Macgregor, APRN
-
John Malcolm, MD
-
Pamela Meyer, APRN
-
Sean X Neath, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D2022946 | Urgent Care at Bedford Medical Park Lab | Certificate of waiver | Nov 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060801000346 | NH | Part B Supplier - Clinic/Group Practice | 6103897129 |
Receives reassigned benefits from 101 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bedford, NH; Wolfeboro, NH; Peterborough, NH; Manchester, NH |
National Provider Directory
- Part of
- CMC Dba Urgent Care at Bedford Medical Park
Locations
5 Washington Pl
Bedford, NH 03110
Phone (603) 314-4567
195 McGregor St
Ste 310
Manchester, NH 03102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
5 Washington Place
Bedford, NH 03110
Mailing address
195 McGregor St
Suite 310
Manchester, NH 03102-3748
Phone (603) 314-4567
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | staff_ucbmp@gohnh.allscripts.net | Direct |
Other providers in Bedford, NH
- Carolyn G Claussen
- Cecilia L. Clemans
- Clementine New Hampshire ABA LLC
- Karen Elizabeth Clever
- Alyssa Cloutier
- Brianna Grace Coco
- Courtney E Coffey
- Katerina Colburn
- Theodore Colby
- Kyle Edward Colella
All providers in Bedford, NH · Urgent Care Clinic/Center 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 Aug 9, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.