Active NPI
Convenientmd LLC
- Urgent Care Clinic/Center
- Plaistow, NH
National Provider Identifier
1285366963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- CONVENIENTMD LLC
- Practice address
- 49 Plaistow Rd
Plaistow, NH 03865-2854 - Phone
- (603) 410-6700
- NPI assigned
- Jun 30, 2022
- Last updated
- Jun 30, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jarod Boissonneault
- Title
- VP, Revenue Cycle Management
- Phone
- (603) 319-6223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | NU | Primary |
Addresses
Primary practice location
49 Plaistow Rd
Plaistow, NH 03865-2854
Mailing address
111 NH Ave
Portsmouth, NH 03801-2864
Phone (603) 410-6700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130410000222 | NH | Part B Supplier - Clinic/Group Practice | 2062667033 |
Receives reassigned benefits from 10 practitioners 18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Windham, NH; Stratham, NH; Portsmouth, NH; Dover, NH; Plaistow, NH; Nashua, NH; Merrimack, NH; Manchester, NH… |
Other NPIs on the same Medicare enrollment 18
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
111 New Hampshire Ave
Portsmouth, NH 03801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656547200000",
"number": "1285366963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NH AVE",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038012864",
"telephone_number": "603-410-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 PLAISTOW RD",
"city": "PLAISTOW",
"state": "NH",
"postal_code": "038652854",
"telephone_number": "603-410-6700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONVENIENTMD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-30",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A",
"authorized_official_last_name": "BOISSONNEAULT",
"authorized_official_first_name": "JAROD",
"authorized_official_title_or_position": "VP, REVENUE CYCLE MANAGEMENT",
"authorized_official_telephone_number": "603-319-6223"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plaistow, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.