NPIMap

Organization Active NPI

Speare Memorial Hospital

Doing business as Speare Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Plymouth, NH
National Provider Identifier
1407690019
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SPEARE MEMORIAL HOSPITAL
Doing business as
Speare Podiatry
Practice address
16 Hospital Rd
Plymouth, NH 03264-1126
Phone
(603) 481-8780
NPI assigned
Jun 20, 2024
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Michelle L. McEwen
Title
President/Ceo
Phone
(603) 536-1120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

16 Hospital Rd
Plymouth, NH 03264-1126

Mailing address

16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 481-8780

Other names 1

  • Speare Podiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH3 enrollments

Enrollment records 3

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
O20070220000493 NH Part A Provider - Critical Access Hospital 1153318068 Receives reassigned benefits from 64 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Plymouth, NH
O20250415000520 NH DME Supplier - Physician - Podiatry 1153318068 Practice locations: Plymouth, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407690019. Details of each certification follow.

Hospital certification: CCN 301311

Legal name
SPEARE MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 5, 2005
Last certification
Sep 23, 2021
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
16 Hospital Rd
Plymouth, NH 32641126
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Speare Memorial HospitalCCN 301311 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Speare Memorial Hospital10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elizabeth Kleiner Individual Corporate DirectorBoard Member Oct 12, 2016
Susan Scrimshaw Individual Corporate Director Oct 21, 2021
John Moulton Individual Corporate DirectorBoard Member Nov 1, 2024
Joseph T Caristi Individual Corporate OfficerCfo Feb 19, 2024
Corporate DirectorCfo Feb 19, 2024
W-2 Managing EmployeeCfo Feb 19, 2024
Operational/Managerial ControlCfo Feb 19, 2024
Margaret Turner Individual Corporate DirectorBoard Member Sep 18, 2014
Patrick B Miller Individual Corporate DirectorBoard Member Sep 18, 2014
Joseph a Ebner Individual Corporate Director Jan 1, 2008
Craig Williams Individual Corporate OfficerCeo Jun 1, 2026
Corporate DirectorCeo Jun 1, 2026
W-2 Managing EmployeeCeo Jun 1, 2026
Kevin I Young Individual Corporate DirectorBoard Member Sep 18, 2014
Walter Johnson Individual Corporate Director Oct 25, 2018
Steven Camerino Individual Corporate Director Oct 23, 2019
Donna Driscoll Individual Corporate DirectorBoard Member Nov 1, 2024
Ken Evans Individual Corporate DirectorBoard Member Nov 1, 2024
Julie Bernier Individual Corporate Director Oct 25, 2018
Eric M Shamansky Individual Corporate DirectorMedical Director Sep 11, 2023
Dolores C Hopper Individual Corporate Director Oct 27, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 11

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.

Affiliated clinicians 219

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 219

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1407690019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL RD",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032641126",
            "telephone_number": "603-481-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL RD",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032641126",
            "telephone_number": "603-481-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "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"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speare Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, NH

Sources for this page

Verify at the official NPI Registry.