NPIMap

Individual provider Active NPI

Kevin Peter Geren Williams

  • Neurology Physician
  • Lebanon, NH
National Provider Identifier
1326575093
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
22798 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5000
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 22798 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-3887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713001759 NH Practitioner - Neurology 0840693719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

730 Ctr St
Suite 9
Auburn, ME 04210-6316
Phone (207) 783-3450

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22798NHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 11, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 11, 2022 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 11, 2022 Accepting new patients
Elliot Professional Services CurrentSince Sep 25, 2023 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

Interoperability endpoints

  • Direct secure messaging: kwilliams157015@direct.solutionhealth.org

Organizations & group practices 4

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 6

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1326575093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-3887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEVIN",
        "middle_name": "PETER GEREN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "22798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.