Individual provider Active NPI

Chris C. Panagoulias, DPM

  • Primary Podiatric Medicine Podiatrist
  • Nashua, NH
National Provider Identifier
1205832391
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
NH123 Issued in NH
Practice address
3 Water St
Suite 101
Nashua, NH 03060-3314
Phone
(603) 883-1321
Fax
(603) 883-1373
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X NH123 NH Primary

Addresses

Primary practice location

3 Water St
Suite 101
Nashua, NH 03060-3314

Mailing address

17 Grant LN
Ogunquit, ME 03907-3647
Phone (603) 883-1321

Other identifiers 2

IdentifierTypeStateIssuer
0308235Y0NH01OtherNHANTHEM
713977OtherNHTUFTS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0123NHMDAddiction (Substance Use Disorder) Counselor
NH123NHMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1205832391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GRANT LN",
            "city": "OGUNQUIT",
            "state": "ME",
            "postal_code": "039073647",
            "telephone_number": "603-883-1321",
            "fax_number": "603-883-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WATER ST",
            "address_2": "SUITE 101",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603314",
            "telephone_number": "603-883-1321",
            "fax_number": "603-883-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAGOULIAS",
        "first_name": "CHRIS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NH",
            "license": "NH123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0308235Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "713977",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.