NPIMap

Organization Active NPI

Catholic Medical Center

Doing business as Granite State Internal Medicine

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1295907533
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CATHOLIC MEDICAL CENTER
Doing business as
Granite State Internal Medicine
Practice address
53 Goffstown Rd
Manchester, NH 03102-2737
Phone
(603) 206-1380
Fax
(603) 206-1378
NPI assigned
Mar 27, 2008
Last updated
Oct 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Andre Therrien
Title
Controller
Phone
(603) 663-8779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

53 Goffstown Rd
Manchester, NH 03102-2737

Mailing address

53 Goffstown Rd
Manchester, NH 03102-2737
Phone (603) 206-1380

Other identifiers 1

IdentifierTypeStateIssuer
30D0998864OtherNHCLIA

Other names 1

  • GRANITE STATE INTERNAL MEDICINE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address staff_gsim@gohnh.allscriptsdirect.net Direct

National Provider Directory

National Provider Directory
Tax ID family
Catholic Healthcare Trust9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: staff_gsim@gohnh.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1295907533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 GOFFSTOWN RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031022737",
            "telephone_number": "603-206-1380",
            "fax_number": "603-206-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GOFFSTOWN RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031022737",
            "telephone_number": "603-206-1380",
            "fax_number": "603-206-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "THERRIEN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "603-663-8779"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "30D0998864",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staff_gsim@gohnh.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "188 Route 101",
            "city": "Bedford",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031105451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GRANITE STATE INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRANITE STATE INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.