NPIMap

Organization Active NPI

Appledore Medical Group Dba Woodbury Family Practice

Doing business as Woodbury Family Practice

  • Family Medicine Physician
  • Newington, NH
National Provider Identifier
1225232184
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
APPLEDORE MEDICAL GROUP DBA WOODBURY FAMILY PRACTICE
Doing business as
Woodbury Family Practice
Practice address
101 Shattuck Way
Suite 6
Newington, NH 03801-7876
Phone
(603) 430-0060
Fax
(866) 835-8949
NPI assigned
Jun 13, 2007
Last updated
Aug 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Authorized official

Name
Kenneth Washington
Title
Vice President
Phone
(703) 650-2907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

101 Shattuck Way
Suite 6
Newington, NH 03801-7876

Mailing address

101 Shattuck Way
Suite 6
Newington, NH 03801-7876
Phone (603) 430-0060

Other names 1

  • Woodbury Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601000165 NH Part B Supplier - Clinic/Group Practice 5698666154 Receives reassigned benefits from 238 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Appledore Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

57 Webster St
Ste 110
Manchester, NH 03104
Phone (603) 622-6491

88 McGregor St
Ste 105
Manchester, NH 03102
Phone (603) 663-6200

25 New Hampshire Ave
Ste 100
Portsmouth, NH 03801
Phone (603) 431-2516

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1225232184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SHATTUCK WAY",
            "address_2": "SUITE 6",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038017876",
            "telephone_number": "603-430-0060",
            "fax_number": "866-835-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SHATTUCK WAY",
            "address_2": "SUITE 6",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038017876",
            "telephone_number": "603-430-0060",
            "fax_number": "866-835-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEDORE MEDICAL GROUP DBA WOODBURY FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "703-650-2907"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodbury Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newington, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.