NPIMap

Individual provider Active NPI

Avery N Nelson, MD

  • Otolaryngology Physician
  • Keene, NH
National Provider Identifier
1457844912
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
24202 Issued in NH
Practice address
580 Court St
North Building, Level 1a
Keene, NH 03431
Phone
(603) 354-5496
Fax
(603) 354-5498
NPI assigned
Jun 10, 2018
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036176719 IL
Otolaryngology Physician 207Y00000X 24202 NH Primary

Addresses

Primary practice location

580 Court St
North Building, Level 1a
Keene, NH 03431

Mailing address

PO Box 810
Hanover, NH 03755-0810
Phone (603) 308-1472

Other practice location 1

302 Randall Rd Ste 202
Geneva, IL 60134-4204
Phone (630) 938-3900

Other identifiers 2

IdentifierTypeStateIssuer
125.072607OtherILILLINOIS DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION
24202OtherNHSTATE OF NEW HAMPSHIRE BOARD OF MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230913002416 NH Practitioner - Otolaryngology 7810244886 Reassigns benefits to 3 organizations
I20251006002545 IL Practitioner - Otolaryngology 7810244886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of South Carolina School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians
Cheshire Medical CenterGroup PAC ID 1456260165, 165 clinicians
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

2635 Church Rd
Suite 101
Aurora, IL 60502-8943
Phone (630) 315-6900

2900 Foxfield Rd
Suite 100
St Charles, IL 60174-5799
Phone (630) 377-6500

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4060

302 Randall Rd
Suite 202
Geneva, IL 60134-4204
Phone (630) 938-3900

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 352-5450

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5454

590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
75.44
Promoting interoperability
100
Improvement activities
40
Cost
72.09

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 29, 2023 Accepting new patients
Cheshire Medical Center CurrentSince Aug 29, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 29, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 29, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 26, 2025 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2025 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

302 Randall Rd
Ste 202
Geneva, IL 60134
Phone (630) 232-1818

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1457844912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810",
            "telephone_number": "603-308-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "address_2": "NORTH BUILDING, LEVEL 1A",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-354-5496",
            "fax_number": "603-354-5498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Randall Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344204",
            "country_code": "US",
            "telephone_number": "630-938-3900",
            "fax_number": "630-938-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AVERY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-10",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036176719",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NH",
            "license": "24202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION",
            "identifier": "125.072607",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW HAMPSHIRE BOARD OF MEDICINE",
            "identifier": "24202",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.