NPIMap

Organization Active NPI

Alice Peck Day Memorial Hospital

Doing business as Emergency Services at Alice Peck Day

  • General Practice Physician
  • Lebanon, NH
National Provider Identifier
1295805950
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
00016 Issued in NH
Legal business name
ALICE PECK DAY MEMORIAL HOSPITAL
Doing business as
Emergency Services at Alice Peck Day
Practice address
10 Alice Peck Day Dr
Lebanon, NH 03766-2647
Phone
(603) 448-7448
Fax
(603) 443-9516
NPI assigned
Nov 9, 2006
Last updated
Apr 23, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ALICE PECK DAY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Susan E Mooney, MDNPI 1740276757
Title
Ceo/President
Phone
(603) 448-3121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 00016 NH
General Practice Physician 208D00000X NU
General Practice Physician 208D00000X 00016 NH Primary

Addresses

Primary practice location

10 Alice Peck Day Dr
Lebanon, NH 03766-2647

Mailing address

10 Alice Peck Day Dr
Lebanon, NH 03766-2647
Phone (603) 448-3121

Other identifiers 2

IdentifierTypeStateIssuer
0009582MedicaidVT
30002661MedicaidNH

Other names 1

  • Emergency Services at Alice Peck Day Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000184 NH Part A Provider - Critical Access Hospital 6103737531 Receives reassigned benefits from 302 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295805950. Details of each certification follow.

Hospital certification: CCN 301305

Legal name
ALICE PECK DAY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2003
Last certification
Jan 20, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
10 Alice Peck Day Dr
Lebanon, NH 37662900
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Alice Peck Day Memorial HospitalCCN 301305 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Alice Peck Day Ecf

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christopher L Hubble Individual Corporate DirectorBoard of Trustee Jan 1, 2024
Gerard I Duprat Individual Corporate DirectorBoard of Directors Jan 1, 2022
Anna Adachi-Mejia Individual Corporate DirectorBoard of Directors Jan 1, 2023
Jenny Barba Individual Corporate DirectorBoard of Directors Jan 1, 2022
Jennifer S Schiffman Individual Corporate DirectorBoard of Directors Jan 1, 2017
Clayton R Adams Individual Corporate DirectorBoard of Directors Jan 1, 2018
David Duncan Individual Corporate DirectorBoard of Trustee Jan 1, 2022
Charles J Wheelan Individual Corporate DirectorBoard of Directors Jan 1, 2018
Marisa D Devlin Individual Corporate DirectorBoard of Directors Jan 1, 2018
Laura M Greer Individual Corporate DirectorBoard of Directors Jan 1, 2023
Scott W Rodi Individual Corporate DirectorBoard of Directors Jan 1, 2019
Michael T Lynch Individual Corporate OfficerCeo Oct 13, 2025 2%
W-2 Managing Employee Oct 13, 2025
Patrick F Jordan Individual Corporate DirectorBoard of Trustee Jan 1, 2019
Dartmouth-Hitchcock Health Organization, Lebanon, NH Corporation Operational/Managerial Control Mar 1, 2016 100%
Laura Gillespie Individual Corporate DirectorBoard of Directors Jan 1, 2024
H. Sloane Mayor Individual Corporate DirectorBoard of Directors Jan 1, 2022
Tegan Deogburn Individual Corporate DirectorDirector - Mso Dec 6, 2023
Patrici Drew Individual Operational/Managerial ControlManager, Enrollment Ops Sep 1, 2025
Michele Perkins Individual Corporate DirectorBoard of Directors Jan 1, 2025
Cybele M Merrick Individual Corporate DirectorBoard of Directors Jan 1, 2021
Barbara Moore Individual Corporate DirectorDirector of Ar Management Apr 1, 2020
Susan E Mooney Individual Corporate OfficerCeo Oct 1, 2012
W-2 Managing Employee Oct 1, 2012
Courtney Tanner Individual Corporate DirectorBoard of Trustee Jan 1, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 530

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 530

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1295805950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662647",
            "telephone_number": "603-448-3121",
            "fax_number": "603-448-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662647",
            "telephone_number": "603-448-7448",
            "fax_number": "603-443-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE PECK DAY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALICE PECK DAY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "603-448-3121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NH",
            "license": "00016",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NH",
            "license": "00016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009582",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30002661",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Services at Alice Peck Day",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.