Individual provider Active NPI

Kristy Blundell

  • Family Nurse Practitioner
  • Londonderry, NH
National Provider Identifier
1356896641
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
055238-23 Issued in NH
Practice address
40 Buttrick Rd
Londonderry, NH 03053-3381
Phone
(603) 434-1919
NPI assigned
Aug 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 055238-23 NH Primary

Addresses

Primary practice location

40 Buttrick Rd
Londonderry, NH 03053-3381

Mailing address

40 Buttrick Rd
Londonderry, NH 03053-3381
Phone (603) 434-1919

Other identifiers 1

IdentifierTypeStateIssuer
3105567MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161116000670 NH Practitioner - Nurse Practitioner 7517246556 Reassigns benefits to 2 organizations
I20230622000402 MA Practitioner - Nurse Practitioner 7517246556

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

275 Mammoth Rd
Manchester, NH 03109-4133

40 Butrrick Rd
Londonderry, NH 03053-3381
Phone (603) 434-1919

Hospital & facility affiliations

  • Vna Home Health and Hospice Services, Inc Home health agency, Manchester, NH, CCN 307003
  • Pathways Healthcare LLC Home health agency, Londonderry, NH, CCN 307095
  • Amedisys Home Health Home health agency, Portsmouth, NH, CCN 307006
  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network CurrentSince Sep 1, 2024 Accepting new patients
Elliot Physicians Network Past Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

40 Buttrick Rd
#B
Londonderry, NH 03053

40 Buttrick Rd
Ste 105
Londonderry, NH 03053

40 Buttrick Rd
Londonderry, NH 03053
Phone (603) 552-1400

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

Interoperability endpoints

  • Direct secure messaging: kblundell46672@direct.solutionhealth.org

Organizations & group practices 3

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 5

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": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1356896641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-434-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-434-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNDELL",
        "first_name": "KRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "055238-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3105567",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Londonderry, NH

Sources for this page

Verify at the official NPI Registry.