NPIMap

Organization Active NPI

Catholic Medical Center

  • Psychiatric Hospital Unit
  • Manchester, NH
National Provider Identifier
1336245240
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
00646 Issued in NH
Legal business name
CATHOLIC MEDICAL CENTER
Practice address
100 McGregor St
Manchester, NH 03102-3730
Phone
(603) 668-3545
Fax
(603) 663-8785
NPI assigned
Sep 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 00646 NH Primary

Addresses

Primary practice location

100 McGregor St
Manchester, NH 03102-3730

Mailing address

100 McGregor St
Manchester, NH 03102-3730
Phone (603) 668-3545

Other identifiers 2

IdentifierTypeStateIssuer
265514OtherNHBCBS PSYCH GRP HF1500
30213023MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041022000879 NH Part B Supplier - Clinic/Group Practice 6103897129 Receives reassigned benefits from 19 practitioners
Practice locations: Manchester, NH

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Catholic Medical CenterManchester, NH, CCN 301823 Federally qualified health center Operational/Managerial Control Jun 16, 2010

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336245240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCGREGOR ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023730",
            "telephone_number": "603-668-3545",
            "fax_number": "603-663-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCGREGOR ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023730",
            "telephone_number": "603-668-3545",
            "fax_number": "603-663-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NH",
            "license": "00646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PSYCH GRP HF1500",
            "identifier": "265514",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30213023",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.