Individual provider Active NPI

Sam Dugan, MD

  • Pediatrics Physician
  • Bedford, NH
National Provider Identifier
1316234099
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4572 Issued in NH
Practice address
360 Route 101
Bedford, NH 03110-5030
Phone
(603) 471-0831
Fax
(603) 471-0890
NPI assigned
Jul 1, 2011
Last updated
Jul 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4572 NH Primary

Addresses

Primary practice location

360 Route 101
Bedford, NH 03110-5030

Mailing address

280 Sylvan LN
Manchester, NH 03102-8419
Phone (603) 935-7700

Other identifiers 1

IdentifierTypeStateIssuer
81374093MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4572NHMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1316234099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SYLVAN LN",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031028419",
            "telephone_number": "603-935-7700",
            "fax_number": "603-935-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105030",
            "telephone_number": "603-471-0831",
            "fax_number": "603-471-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "4572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81374093",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.