Individual provider Active NPI

Donna Marie Hedberg

  • Psychiatric/Mental Health Nurse Practitioner
  • Portsmouth, NH
National Provider Identifier
1265067789
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
03146-23 Issued in NH
Practice address
1145 Sagamore Ave
Portsmouth, NH 03801-5585
Phone
(603) 433-5075
NPI assigned
Mar 4, 2020
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 03146-23 NH Primary

Addresses

Primary practice location

1145 Sagamore Ave
Portsmouth, NH 03801-5585

Mailing address

1145 Sagamore Ave
Portsmouth, NH 03801-5503
Phone (603) 431-6703

Other practice location 1

20 Ladd St Ste 411
Portsmouth, NH 03801-4087
Phone (603) 205-2953

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
I20201216002914 NH Practitioner - Nurse Practitioner 7315359247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seacoast Mental Health Center IncGroup PAC ID 0749240208, 45 clinicians
Life Management for Adults PLLCGroup PAC ID 1355607490, 3 clinicians

Practice addresses (Care Compare)

1145 Sagamore Ave
Portsmouth, NH 03801-5503
Phone (603) 431-6703

20 Ladd St
FL 4
Portsmouth, NH 03801-4087
Phone (603) 205-2953

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03146-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Mental Health Center, Inc. CurrentSince Nov 9, 2020 Accepting new patients
Life Management for Adults PLLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

1145 Sagamore Ave
Portsmouth, NH 03801
Phone (603) 431-6703

20 Ladd St
Fl 4
Portsmouth, NH 03801
Phone (603) 205-2953

20 Ladd St
Ste 412
Portsmouth, NH 03801

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1265067789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015503",
            "telephone_number": "603-431-6703",
            "fax_number": "603-430-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015585",
            "telephone_number": "603-433-5075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Ladd St Ste 411",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038014087",
            "country_code": "US",
            "telephone_number": "603-205-2953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDBERG",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "03146-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.