Active NPI
Derek Andrew Lautieri, ATC
- Specialist
- Manchester, NH
National Provider Identifier
1326183856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0149
- Practice address
- 2108 River Rd
Manchester, NH 03104-1302 - Phone
- (603) 669-4524
- Fax
- (603) 641-9206
- NPI assigned
- Feb 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0149 | NH | Primary |
Addresses
Primary practice location
2108 River Rd
Manchester, NH 03104-1302
Mailing address
20A Richardson Dr
Derry, NH 03038-4919
Phone (603) 669-4524
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0149 | NH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326183856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20A RICHARDSON DR",
"city": "DERRY",
"state": "NH",
"postal_code": "030384919",
"telephone_number": "603-669-4524",
"fax_number": "603-641-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 RIVER RD",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031041302",
"telephone_number": "603-669-4524",
"fax_number": "603-641-9206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAUTIERI",
"first_name": "DEREK",
"middle_name": "ANDREW",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NH",
"license": "0149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.