Teresa Ann Ponn, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

13176 Issued in NH

Practice address

185 Queen City Ave
Manchester, NH 03101-7100

Phone

(603) 668-3067

Fax

(603) 668-0164

NPI assigned

Nov 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Teresa Ann Bicknell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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
  NPD (past)
• Elliot Professional Services

  • Psychiatry Physician
  • Manchester, NH
  • NPI 1669431466
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1245213461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT BREAST HEALTH CENTER",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017100",
            "telephone_number": "603-668-3067",
            "fax_number": "603-668-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017100",
            "telephone_number": "603-668-3067",
            "fax_number": "603-668-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONN",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "13176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30206042",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "BICKNELL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Denisa Poljakovic
• Emily Pollard
• Ann-Marie Pollock, OT
• Callie Ruth Pomeroy, LCMHC
• Emelyne Pompee, RN
• Lisa Poole, L.M.T.
• Yvette Rodriguez Poole
• Tanya Marie Popoloski, MSW, LICSW
• Danielle Alexandra Porbunderwala, D.O.
• David Porbunderwala, M.D.

• Surgery Physician in Manchester, NH
• Providers in Manchester, NH by specialty
• Surgery Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.