Individual provider Active NPI

Jennifer L John, PA-C

  • Surgical Physician Assistant
  • Concord, NH
National Provider Identifier
1285668756
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0378 Issued in NH
Practice address
264 Pleasant St
Concord, NH 03301-2551
Phone
(603) 224-3368
Fax
(603) 224-7815
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0378 NH Primary

Addresses

Primary practice location

264 Pleasant St
Concord, NH 03301-2551

Mailing address

264 Pleasant St
Concord, NH 03301-2551
Phone (603) 224-3368

Other identifiers 1

IdentifierTypeStateIssuer
30331145MedicaidNH

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
I20101201000800 NH Practitioner - Physician Assistant 9739375817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 Boulder Point Dr
Plymouth, NH 03264-3168
Phone (603) 224-3368

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0378NHMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 1, 2024 Accepting new patients
Concord Orthopaedics Professional Association CurrentSince Sep 8, 2010 Accepting new patients
Concord Orthopaedics Professional Association CurrentSince Sep 8, 2010 Accepting new patients

Locations

57 Regional Dr
Ste 1
Concord, NH 03301

264 Pleasant St
Concord, NH 03301

6 Tsienneto Rd
Ste 200
Derry, NH 03038
Phone (603) 426-5222

103 Boulder Point Dr
Plymouth, NH 03264
Phone (603) 536-1284

Interoperability endpoints

  • Direct secure messaging: jennifer.john.1@32845.direct.athenahealth.com

Organizations & group practices 3

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.

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1285668756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-224-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-224-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30331145",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.