Individual provider Active NPI

Kenneth Yeomans, RN

  • Critical Care Medicine Registered Nurse
  • Manchester, NH
National Provider Identifier
1366141665
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
RN2351768 Issued in MA
Practice address
7 Estate Dr
Manchester, NH 03104-4034
Phone
(603) 932-9044
NPI assigned
Feb 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN2351768 MA Primary

Addresses

Primary practice location

7 Estate Dr
Manchester, NH 03104-4034

Mailing address

7 Estate Dr
Manchester, NH 03104-4034
Phone (603) 932-9044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003002 MA Practitioner - Nurse Practitioner 8224568761 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2351768MAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Current Accepting new patients
Cardiovascular Center at Tufts Medical Center, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Pratt Medical Group, Inc CurrentSince Mar 1, 2025 Accepting new patients
Pratt Medical Group, Inc CurrentSince Mar 1, 2025 Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#3
Boston, MA 02111
Phone (617) 636-1636

Interoperability endpoints

  • Direct secure messaging: kyeomans30855@tuftsmedicine.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1366141665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ESTATE DR",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044034",
            "telephone_number": "603-932-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ESTATE DR",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044034",
            "telephone_number": "603-932-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEOMANS",
        "first_name": "KENNETH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "RN2351768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.