NPIMap

Organization Active NPI

Skilled Medical Provider Group PLLC

  • Internal Medicine Physician
  • Durham, NH
National Provider Identifier
1386952844
Registry record updated Sep 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SKILLED MEDICAL PROVIDER GROUP PLLC
Practice address
13 Surrey LN
Durham, NH 03824-4413
Phone
(603) 459-4522
NPI assigned
Sep 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2010

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

Authorized official

Name
Dr. Paul P Bergeron, MD
Title
Manager
Phone
(603) 459-4522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

13 Surrey LN
Durham, NH 03824-4413

Mailing address

13 Surrey LN
Durham, NH 03824-4413
Phone (603) 459-4522

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284768000000",
    "number": "1386952844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SURREY LN",
            "city": "DURHAM",
            "state": "NH",
            "postal_code": "038244413",
            "telephone_number": "603-459-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 SURREY LN",
            "city": "DURHAM",
            "state": "NH",
            "postal_code": "038244413",
            "telephone_number": "603-459-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILLED MEDICAL PROVIDER GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-18",
        "last_updated": "2010-09-18",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "603-459-4522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.