NPIMap

Organization Active NPI

Speare Memorial Hospital

  • Emergency Medicine Physician
  • Plymouth, NH
National Provider Identifier
1346487956
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SPEARE MEMORIAL HOSPITAL
Practice address
16 Hospital Road
Emergency Medicine
Plymouth, NH 03264
Phone
(603) 238-6480
NPI assigned
Jan 20, 2009
Last updated
Oct 4, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SPEARE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Authorized official

Name
Michelle L McEwen, PRESIDENT/CEO
Title
President/Ceo
Phone
(603) 536-1120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

16 Hospital Road
Emergency Medicine
Plymouth, NH 03264

Mailing address

16 Hospital Rd
Emergency Department
Plymouth, NH 03264-1126

Other identifiers 2

IdentifierTypeStateIssuer
1001953MedicaidVT
3081034MedicaidNH

Other names 1

  • Emergency Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823001172 NH Part B Supplier - Clinic/Group Practice 1153318068 Receives reassigned benefits from 108 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bristol, NH; Meredith, NH; Plymouth, NH

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Speare Memorial Hosp

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": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1346487956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL RD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032641126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL ROAD",
            "address_2": "EMERGENCY MEDICINE",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "03264",
            "telephone_number": "603-238-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARE MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPEARE MEMORIAL HOSPITAL",
        "enumeration_date": "2009-01-20",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "603-536-1120",
        "authorized_official_credential": "PRESIDENT/CEO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001953",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3081034",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Plymouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.