Individual provider Active NPI

Jennifer Anne Ganem, MS, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Londonderry, NH
National Provider Identifier
1255340469
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
037416-23 Issued in NH
Practice address
50 Nashua Rd Ste 208
Londonderry Square
Londonderry, NH 03053-3438
Phone
(603) 432-3399
Fax
(603) 432-3396
NPI assigned
Aug 5, 2006
Last updated
Nov 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0374162308 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 037416-23 NH Primary

Addresses

Primary practice location

50 Nashua Rd Ste 208
Londonderry Square
Londonderry, NH 03053-3438

Mailing address

50 Nashua Rd Ste 208
Londonderry Square
Londonderry, NH 03053-3438
Phone (603) 432-3399

Other names 1

  • Jennifer Ganem Lafond Former name

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
I20050622000957 NH Practitioner - Nurse Practitioner 6608811419 Practice locations: Londonderry, NH

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

50 Nashua Rd
Londonderry, NH 03053-3438
Phone (603) 432-3399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
037416-23NHMDPsychiatric/Mental Health Nurse Practitioner
0374162308NHMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1255340469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NASHUA RD STE 208",
            "address_2": "LONDONDERRY SQUARE",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533438",
            "telephone_number": "603-432-3399",
            "fax_number": "603-432-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NASHUA RD STE 208",
            "address_2": "LONDONDERRY SQUARE",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533438",
            "telephone_number": "603-432-3399",
            "fax_number": "603-432-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANEM",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MS, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "0374162308",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "037416-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LAFOND",
            "middle_name": "GANEM",
            "credential": "MS, APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Londonderry, NH

Sources for this page

Verify at the official NPI Registry.