Active NPI
Convenientmd LLC
- Clinical Medical Laboratory
- Salem, NH
National Provider Identifier
1467048348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- CONVENIENTMD LLC
- Practice address
- 8 Industrial Way Ste 4
Salem, NH 03079-4873 - Phone
- (603) 685-3340
- NPI assigned
- Dec 15, 2020
- Last updated
- Dec 15, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jarod Boissonneault
- Title
- Director of Revenue Cycle MGT
- Phone
- (603) 319-6223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
8 Industrial Way Ste 4
Salem, NH 03079-4873
Mailing address
111 NH Ave
Portsmouth, NH 03801-2864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130410000222 | NH | Part B Supplier - Clinic/Group Practice | 2062667033 |
Receives reassigned benefits from 10 practitioners 18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Windham, NH; Stratham, NH; Portsmouth, NH; Dover, NH; Plaistow, NH; Nashua, NH; Merrimack, NH; Manchester, NH… |
Other NPIs on the same Medicare enrollment 18
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607990400000",
"number": "1467048348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NH AVE",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038012864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 INDUSTRIAL WAY STE 4",
"city": "SALEM",
"state": "NH",
"postal_code": "030794873",
"telephone_number": "603-685-3340"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONVENIENTMD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A",
"authorized_official_last_name": "BOISSONNEAULT",
"authorized_official_first_name": "JAROD",
"authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MGT",
"authorized_official_telephone_number": "603-319-6223"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.