NPIMap

Organization Active NPI

Elliot Physicians Network

  • Family Medicine Physician
  • Bedford, NH
National Provider Identifier
1154310910
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELLIOT PHYSICIANS NETWORK
Practice address
15 Constitution Dr
Elliot Family Medicine at Bedford Village
Bedford, NH 03110-6042
Phone
(603) 472-7233
Fax
(603) 472-9188
NPI assigned
Oct 14, 2005
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PHYSICIANS NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Richard P. Herman
Title
Director of Operations & Finance
Phone
(603) 663-5766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

15 Constitution Dr
Elliot Family Medicine at Bedford Village
Bedford, NH 03110-6042

Mailing address

15 Constitution Dr
Elliot Family Medicine at Bedford Village
Bedford, NH 03110-6042
Phone (603) 472-7233

Other identifiers 2

IdentifierTypeStateIssuer
CG2227OtherNHRR MEDICARE GRP #
30210578MedicaidNH

Other names 1

  • Elliot Family Medicine at Bedford Village Other name

National Provider Directory

National Provider Directory
Tax ID family
Elliot Physician Network28 organizations share this tax ID, including this one
Part of
Elliot Physician Network

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1154310910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CONSTITUTION DR",
            "address_2": "ELLIOT FAMILY MEDICINE AT BEDFORD VILLAGE",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106042",
            "telephone_number": "603-472-7233",
            "fax_number": "603-472-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CONSTITUTION DR",
            "address_2": "ELLIOT FAMILY MEDICINE AT BEDFORD VILLAGE",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106042",
            "telephone_number": "603-472-7233",
            "fax_number": "603-472-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PHYSICIANS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PHYSICIANS NETWORK",
        "enumeration_date": "2005-10-14",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "603-663-5766"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP #",
            "identifier": "CG2227",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30210578",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elliot Family Medicine at Bedford Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.