Molly Katherine Clancy, ANP

Key facts

NPI

1144538422

Entity type

Individual (NPI type 1)

Primary specialty

Adult Health Nurse Practitioner 363LA2200X

License

RN261889 (MA)

Practice address

1 Elliot Way Ste 100
Manchester, NH 03103-3599

Phone

(603) 627-1669

NPI assigned

Sep 20, 2010

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

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.

• Elliot Professional Services Internal Medicine Physician · Manchester, NH · NPI 1285627935
  Medicare reassignment Care Compare group NPD NH

Hospital & facility affiliations 1

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

• Elliot Hospital of the City of Manchester General Acute Care Hospital · Manchester, NH · NPI 1902996028
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elliot Professional Services (429 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elliot Hospital Hospital · Manchester, NH · CCN 300012

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

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 2, 2018.

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1144538422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY STE 100",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033599",
            "telephone_number": "603-627-1669",
            "fax_number": "603-624-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY STE 100",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033599",
            "telephone_number": "603-627-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "MOLLY",
        "middle_name": "KATHERINE",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN261889",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN261889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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