NPIMap

Organization Active NPI

Granite State Physical Therapy Hooksett PLLC

  • Physical Therapist
  • Hooksett, NH
National Provider Identifier
1437218872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2457 Issued in NH
Legal business name
GRANITE STATE PHYSICAL THERAPY HOOKSETT PLLC
Practice address
1461 Hooksett Rd
BLDG. C, Unit 10
Hooksett, NH 03106-1882
Phone
(603) 695-6767
Fax
(603) 695-6766
NPI assigned
Dec 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brian M VervilleNPI 1538246699
Title
Physical Therapist
Phone
(603) 695-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2457 NH Primary

Addresses

Primary practice location

1461 Hooksett Rd
BLDG. C, Unit 10
Hooksett, NH 03106-1882

Mailing address

1461 Hooksett Rd
BLDG. C, Unit 10
Hooksett, NH 03106-1882
Phone (603) 695-6767

Other identifiers 1

IdentifierTypeStateIssuer
30393077MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000339 NH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153321401 Receives reassigned benefits from 16 practitioners
Practice locations: Concord, NH; Gilford, NH; Hooksett, NH

National Provider Directory

National Provider Directory

Locations

6 Loudon Rd
Ste 5
Concord, NH 03301
Phone (603) 410-6309

369 Hounsell Ave
Ste 8
Gilford, NH 03249
Phone (603) 527-8015

1461 Hooksett Rd
Bldg C
Hooksett, NH 03106
Phone (603) 695-6767

1461 Hooksett Rd
Ste A6
Hooksett, NH 03106
Phone (603) 695-6767

1558 Hooksett Rd
Ste 5
Hooksett, NH 03106
Phone (603) 695-6767

1558 Hooksett Rd
Ste C4
Hooksett, NH 03106
Phone (603) 695-6767

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437218872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 HOOKSETT RD",
            "address_2": "BLDG. C, UNIT 10",
            "city": "HOOKSETT",
            "state": "NH",
            "postal_code": "031061882",
            "telephone_number": "603-695-6767",
            "fax_number": "603-695-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 HOOKSETT RD",
            "address_2": "BLDG. C, UNIT 10",
            "city": "HOOKSETT",
            "state": "NH",
            "postal_code": "031061882",
            "telephone_number": "603-695-6767",
            "fax_number": "603-695-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE STATE PHYSICAL THERAPY HOOKSETT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VERVILLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "603-695-6767"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30393077",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hooksett, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.