NPIMap

Organization Active NPI

Elliot Professional Services

  • Emergency Medicine Physician
  • Londonderry, NH
National Provider Identifier
1346435211
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ELLIOT PROFESSIONAL SERVICES
Practice address
40 Buttrick Rd
Elliot Urgent Care Center
Londonderry, NH 03053-3381
Phone
(603) 552-1550
Fax
(603) 552-1599
NPI assigned
Sep 13, 2007
Organization subpart
Yes
Parent organization
ELLIOT PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Richard P. Herman
Title
Director of Operations & Finance
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

40 Buttrick Rd
Elliot Urgent Care Center
Londonderry, NH 03053-3381

Mailing address

40 Buttrick Rd
Elliot Urgent Care Center
Londonderry, NH 03053-3381
Phone (603) 552-1550

Other identifiers 2

IdentifierTypeStateIssuer
CK3360OtherNHRR MEDICARE
30214693MedicaidNH

Other names 1

  • Elliot Urgent Care at Londonderry Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D1059581Elliot Urgent Care Poct Lab at Londonderry40 Buttrick Rd, Londonderry, NH 03053ComplianceMay 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Elliot Professional Ser35 organizations share this tax ID, including this one
Part of
Elliot Professional Ser

Other organizations with this tax ID 34

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

View all 34

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1346435211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "address_2": "ELLIOT URGENT CARE CENTER",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-552-1550",
            "fax_number": "603-552-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "address_2": "ELLIOT URGENT CARE CENTER",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-552-1550",
            "fax_number": "603-552-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PROFESSIONAL SERVICES",
        "enumeration_date": "2007-09-13",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK3360",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30214693",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elliot Urgent Care at Londonderry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Londonderry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.