Individual provider Active NPI

Imani Mareill Gaetjens-Oleson

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1205723301
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
082603-23 Issued in NH
Practice address
145 Hollis St
Manchester, NH 03101-1235
Phone
(603) 626-9500
NPI assigned
Jun 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 082603-23 NH Primary

Addresses

Primary practice location

145 Hollis St
Manchester, NH 03101-1235

Mailing address

145 Hollis St
Manchester, NH 03101-1235
Phone (603) 626-9500

Other practice location 1

510 Old Candia Rd
Candia, NH 03034-2400
Phone (603) 420-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251229002466 NH Practitioner - Nurse Practitioner 8022504190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag Health 30 clinicians

Practice addresses (Care Compare)

145 Hollis St
Manchester, NH 03101-1235
Phone (603) 626-9500

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082603-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Health CurrentSince Nov 14, 2025 Accepting new patients
Amoskeag Health CurrentSince Nov 14, 2025 Accepting new patients

Locations

145 Hollis St
Manchester, NH 03101

Interoperability endpoints

  • Direct secure messaging: imani.gaetjens-oleson.1@28516.direct.athenahealth.com

Organizations & group practices 18

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 18

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": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1205723301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Old Candia Rd",
            "address_purpose": "LOCATION",
            "city": "Candia",
            "state": "NH",
            "postal_code": "030342400",
            "country_code": "US",
            "telephone_number": "603-420-2686",
            "fax_number": "603-956-7980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAETJENS-OLESON",
        "first_name": "IMANI",
        "middle_name": "MAREILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "082603-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.